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Two subtle but important bony injuries are seen:
- bony fragment from the lateral tibial condyle on the AP view represents a Segond fracture due to avulsion at the anterolateral capsular attachment. Segond fractures have a very high association with ACL tears and meniscal injuries and should prompt further evaluation with an MRI.
- avulsed bone fragment is seen anteriorly in the intercondylar region of the tibia due to avulsion of the tibial spine at the distal ACL attachment.