When interpreting knee radiographs, we must be aware of fractures associated with ACL injury
- Segond fracture
- Lateral femoral condyle osteochondral fracture (corresponding to "deep sulcus" sign seen on MR images),
- Pivot-shift fracture of the posterolateral tibia
- Tibial spine avulsion fracture.
In this patient there is linear fracture of the posterolateral tibia consistent with segond fracture and fibular fractures. Patient had associated rupture of femoral footprint of ACL. We must be careful of these secondary signs when evaluating MRI as these are sometimes easy to miss on MRI.