E1562. Residents’ Survival Guide for Avulsion Fractures Around the Knee and Mimickers
  1. Mohammed Sabawi; Hamad Medical Corporation
  2. Usman Nabi; Hamad General Hospital
  3. Loai Aker; Hamad General Hospital
  4. Alaa Altaie; Hamad Medical Corporation
The complex nature of knee joint with its numerous tendinous, ligamentous, and meniscal attachments, which render it susceptible to complicated injuries after trauma. These avulsion injuries of the knee are variable and usually have a subtle appearance at conventional radiography, hence advanced imaging modalities, particularly magnetic resonance imaging, are crucial and can provide additional information to delineate the extent of damage. Radiologists’ aim is to accurately address mechanism of injury and to understand the underlying soft tissue damage which is frequently associated.

Educational Goals / Teaching Points
To review applied radiological anatomy of the knee. To identify the common and uncommon avulsion injuries of the knee using different imaging modalities in a case-based format. To provide tips and tricks for in-training and young radiologists in recognizing these injuries at initial presentation and on follow-up. To review the common mimickers of avulsion fractures encountered in clinical practice.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Background information. Applied radiological anatomy of the knee. Cases: Segond Fracture (acute and old) Reverse Segond fracture ACL Avulsion Fracture PCL Avulsion Fracture (acute and healed) Arcuate Complex Avulsion Fracture Iliotibial Band Avulsion Fracture Biceps Femoris Tendon Avulsion Fracture Semimembranosus Tendon Avulsion Fracture Quadriceps Tendon Avulsion Fracture Patellar tendon avulsion fracture. Sinding-Larsen-Johansson Syndrome Osgood-Schlatter Disease. Jumper’s knee. Bipartite and tripartite patella. Pellagerina Steida lesion. Avulsion fracture of femoral attachment of deep medial collateral ligament Conclusion References

In this educational exhibit, we described a variety of acute and chronic avulsion knee fractures, underlying mechanism of injury and some of substantial associated soft tissue injuries. The key imaging findings of each injury and their common mimics are discussed as well. Accurate knowledge of the anatomy, pattern of injury, and characteristic imaging features is essential to make the correct diagnosis. Early identification of these injuries is crucial to facilitate appropriate patient workup and prevent morbidity associated with delayed treatment.