Radedasia

Segond Fracture MRI Appearance

Segond Fractures are fractures of the lateral tibial plateau often associated with ACL tears.

Where do the Occur?

Lateral tibial plateau, just posterior to the attachment of the ilio tibial band.

Is it an avulsion fracture of the ITB?

Its thought to be related to the tibial insertion of the anterolateral ligament. However this ligament is not distinctly identified on MRI and the best landmark is to look immediately posterior to the ITB insertion.

What to look for on X-ray?

Small avulsion/ flake type fracture of the lateral tibial plateau.

What to look for on MRI?

  1. Bone marrow oedema immediately posterior to the ITB insertion. May only be seen as an area of bone marrow oedema rather than the classic fracture fragment seen on x-ray.
  2. Bone fragment or loss of cortical margin immediately posterior to the ITB

 

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mri knee segond fracture xray radiology education asia

Image Above: X-ray shows fracture fragment ( blue arrow)) adjacent to lateral tibial plateau. ITB ( yellow arrow) is intact and normal. MRI third image Bone marrow oedema ( blue arrow) low signal fracture line seen immediately posterior to ITB insertion.

mri knee segond fracture fragment radiology education asia

Image Above: Segond Fracture normal ITB insertion ( yellow arrow). Fracture of the lateral cortex ( blue arrows) posterior to ITB insertion.

 

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What’s the Purpose of the Tuesday Tips?: Many of the Tuesday Tip posts arise from questions or difficulties that people bring up in the Mini Fellowships. These posts are meant to be short and concise to answer those questions.

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December 13, 2017