Acute Stieda fracture
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The frontal projection is a little rotated. There is a small avulsion fracture from the medial epicondyle of the distal femur, at the expected site of the medial collateral ligament proximal attachment. Large joint effusion with no lipohemarthrosis.
Acute appearance of a Stieda fracture, due to avulsion of the proximal (femoral) attachment of the MCL.