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Finding-the-Path: MRI of the knee

MRI of the knee

Coronal T1 MRI of the knee shows an avulsion fracture of the lateral aspect of the proximal tibia (white arrow) and a linear fracture of the proximal tibia with hemorrhage and marrow edema (black arrows). On sagittal T2-weighted images, the anterior cruciate ligament is torn (white arrows). There is hemorrhage and edema in the proximal tibia (black arrow).

Discussion

Avulsion fractures of the lateral aspect of the proximal tibia below the articular surface are called Segond fractures. The mechanism of injury is internal rotation and varus stress, which causes abnormal tension on the central portion of the lateral capsular ligament. Segond fractures may be accompanied by other injuries: The first imaging after injury of the knee is a plain radiograph. When a Segond fracture is identified on the plain film or suspected after clinical examination, MRI is indicated to evaluate the anterior cruciate ligament and possible injuries to menisci and other structures.
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