Case 15 - 40 year old male with twisting injury while skiing
40 year old male with recent left knee injury while skiing.
- In addition to having a moderate joint effusion, the effusion has a fluid-fluid level, best seen on the sagittal T2 images, indicating hemarthrosis from an acute injury.
- There are at least two areas of contusion along the posterolateral tibial plateau, as well as the lateral femoral condyle.
- There is discontinuity of the hypointense cortex along the lateral tibial plateau indicating a small avulsion fracture; in this location, this injury is termed a Segond fracture. Second fractures are important because they have a very high association with ACL injury.
- While most ACL tears results from valgus stress on the knee, this pattern is a result of internal rotation and varus stress on the knee, which commonly occurs with skiing.
- Indeed, when we inspect the ACL we see discontinuity of the ligament compatible with a complete tear.
- Medial or lateral meniscal tears are frequently associated with this pattern of injuries; however, in this case the menisci appear intact.
- In summary, this patient has an ACL tear with a Segond fracture and kissing contusions.
Accession: CL0095
Study description: MR JOINT LOWER KNEE-LT