Season 1 Case 45

History: trauma

Season 1 Case 45

Case 45     History: trauma

Answer:

CLICK HERE FOR ANSWER

image
Case 45 Answer: Segond Fracture.

Yes this one is HUGE ( this is the most obvious finding on the image I gave you - see full notes below)

Segond Fracture is a fracture of the lateral aspect of the tibial plateau, famous for it’s association with internal knee soft tissue injury (ACL tears of ~75%, with less frequent association with meniscal injuries).

Don’t get it confused with an avulsive fracture of the fibular head - ie the “arcuate sign” which is associated with posterolateral corner injuries

BUT WAIT, check out the lateral closely - this case has BOTH (see below) and I do think you can make both out on the AP as well.

Red arrow = Segond fracture

Yellow arrow = fibular head avulsion fracture (ie “arcuate sign”)

Short reference:

Segond fracture: http://radiopaedia.org/articles/segond-fracture

more detail: http://radiographics.rsna.org/content/28/6/1755.full

Arcuate sign: http://radiology.rsna.org/content/244/2/620.full

Time for a short break and we’ll get started again with the new academic year in July.

Best of luck to all the 4th years with the oral boards. You will all do GREAT! Pretty soon it will all be over and your real life can truly begin!

To everyone else, have a terrific summer and keep up the good work.