Segond fractures are an avulsion fracture of the proximal-lateral tibia and represents a bony avulsion of the anterolateral ligament. They are pathognomonic for an ACL tear. The presence of the tibial spine fracture and large hemarthrosis also indicates a likely ACL injury. 

MRI should be utilized to further investigate this knee injury and the patient should have an orthopedic specialist opinion.

This patient underwent knee arthroscopy and repair of their his ACL.