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Lateral tibial rim (Segond) fractures: MR imaging characteristics
W N Weber1, C H Neumann, J A Barakos
1Department of Radiology, University of California, San Francisco 94143.
Abstract:
The magnetic resonance (MR) imaging characteristics of lateral tibial rim (Segond) fractures and their associated injuries were reviewed in 12 patients with radiographic evidence of this fracture. Bone marrow adjacent to the fracture emitted a focally abnormal MR signal, which indicated an injury of the lateral capsular junction. The Segond fragment, however, was seen on MR images in only four of 12 patients. Associated ligamentous and meniscal injuries identified with MR imaging and arthroscopy involved the anterior (n = 11) and medial (n = 7) cruciate ligaments and the lateral (n = 4) and medial (n = 1) menisci. Focal bone marrow edema was due to injury of the lateral capsular junction. MR imaging evidence of such edema should indicate the presence of a lateral capsular injury and fracture, if one has not already been demonstrated with conventional radiography. A high association of Segond fractures with tears of the anterior cruciate ligament was confirmed, and MR imaging signs of a Segond fracture may therefore be used as indirect evidence for tears of that ligament.
Insights
Magnetic resonance (MR) imaging reveals bone marrow edema indicating lateral capsular junction injury in Segond fractures. This finding suggests associated ligament and meniscal damage, particularly to the anterior cruciate ligament.
Area of Science:
- Orthopedic imaging
- Sports medicine
- Radiology
Background:
- Segond fractures, or lateral tibial rim fractures, are often associated with significant intra-articular injuries.
- Conventional radiography may not always reveal the full extent of associated injuries.
- Magnetic resonance (MR) imaging offers detailed visualization of bone and soft tissues.
Purpose of the Study:
- To characterize the MR imaging findings of Segond fractures.
- To evaluate associated ligamentous and meniscal injuries in patients with Segond fractures.
- To determine the utility of MR imaging in detecting these associated injuries.
Main Methods:
- Retrospective review of MR imaging in 12 patients with radiographic Segond fractures.
- Correlation of MR findings with arthroscopic results where available.
- Analysis of bone marrow edema and specific fracture fragment visualization.
Main Results:
- Focal bone marrow edema adjacent to the fracture indicated lateral capsular junction injury.
- Segond fracture fragments were visible on MR imaging in only 4 of 12 patients.
- High association with anterior cruciate ligament (11/12) and lateral meniscus (4/12) tears was observed.
Conclusions:
- MR imaging findings of bone marrow edema are indicative of lateral capsular injury and potential Segond fracture.
- MR imaging is crucial for identifying associated ligamentous and meniscal injuries, especially anterior cruciate ligament tears.
- Abnormal MR signal in the bone marrow adjacent to the fracture is a key indicator of associated injuries.
