- ACL/PCL tear
- Capsular disruption
- Displaced avulsion fracture of the tibial spine
- Meniscal tear
The oval-shaped bone density projecting in the intercondylar notch region is a displaced avulsion fracture of the tibial spine, otherwise known as a tibial eminence fracture or ACL avulsion fracture.
Learnings/What to Look for
- ACL avulsion fractures are often associated with sports or other vigorous activity in children between the ages of 8 and 13 years
- The fracture occurs secondary to relative weakness of incompletely ossified tibial eminence compared to native ACL fibres
Pearls for Urgent Care Management and Considerations for Transfer
- Evaluate and document neurovascular status
- Assess for more serious considerations such as open fracture, compartment syndrome, or fracture/dislocation in the proximal or distal joint
- The knee should be immobilized in the urgent care center, with transfer to the ED or referral to an orthopedist as needed. Severe injury may require surgery
Acknowledgment: Images and case presented by Experity Teleradiology (www.experityhealth.com/teleradiology).