Type:
Educational Exhibit
Keywords:
Musculoskeletal joint, Conventional radiography, MR, Education, Trauma
Authors:
M. C. SOWRABHA, B. Nagabhushana Reddy, P. Reddy, B. B. Das, S. T. Prabhakar, S. Viswamitra; BANGALORE/IN
DOI:
10.26044/ecr2019/C-3258
Background
• The Knee is a complicate joint with numerous tendinous,
ligamentous,
and meniscal attachments,
which make it particularly vulnerable to complex injuries after trauma.
• A variety of avulsion fractures of the knee can occur,
including Segond and reverse Segond fractures; avulsions of the anterior and posterior cruciate ligaments; arcuate complex avulsion; iliotibial band avulsion; avulsions of the biceps femoris,
semimembranosus,
and quadriceps tendons; Sinding-Larsen-Johansson syndrome; and Osgood-Schlatter disease.
• First imaging modality of choice is conventional radiography and these fractures often have a subtle appearance.
• An avulsion fracture involves the detachment of a bone fragment that results from the pulling away of a ligament,
tendon,
or joint capsule from its point of attachment on a bone.
• Prompt diagnosis of these typically destabilizing injuries is the first step in preventing the long-term consequences of delayed treatment,
specifically the chronic morbidity associated with posttraumatic osteoarthritis.
• The knee joint remains particularly susceptible to avulsion fractures due to its numerous tendinous,
ligamentous,
and meniscal attachments.
IMPORTANT TO RECOGNISE
• Relatively benign appearance of these small fragments makes it difficult to pick up.
• May be taken as inconsequential by inexperienced.
• But are harbinger of potentially more severe underlying damage to the major stabilizing structures of the joint.
ANATOMY OF LIGAMENTOUS ATTACHMENT OF KNEE- Refer to Image 1 and 2.