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Review areas of the knee that include insertion and origin points of ligaments, tendons and capsular attachments. Each is an important region to ensure no subtle avulsion fracture is present.
Case Discussion
Knee radiographs can be deceptive, small avulsion fractures of the knee more often than not are associated with instability and internal derangement. It is important to scrutinise these check areas for small slivers of avulsed bone.
From lateral to medial, superior to inferior 1:
- origin of the lateral collateral ligament at the lateral femoral condyle
- origin of the anterior cruciate ligament at the posterior-lateral portion of the intercondylar notch femoral condyle
- insertion of the lateral capsule at the lateral tibia (at the joint line)
- insertion of the arcuate ligament at the fibular styloid
- insertion of the lateral collateral ligament and the bicep femoris tendon (conjoint tendon) at the fibular head
- insertion of the iliotibial band at Gerdy tubercle of the tibia
- origin of the medial collateral ligament at the medial femoral condyle
- origin of the posterior cruciate ligament at the anterior middle portion of the medial condyle
- insertion of the deep meniscofemoral ligament of the medial collateral ligament at the medial tibia (at the joint line)
- insertion of the superficial fibers of the medial collateral ligament at the anteromedial tibia 5cm distal to the tibiofemoral joint
- anterior cruciate ligament insertion at the medial portion of the tibial spine
- posterior cruciate ligament insertion at the posterior medial portion of the tibial plateau