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The Segond fracture is an avulsion fracture of the lateral tibial plateau and is considered pathognomonic for anterior cruciate ligament (ACL) injury. A case of a Segond fracture occurring with a clinically, radiologically and arthroscopically intact ACL is presented. This was associated with a serious injury to the posterolateral corner requiring surgical reconstruction. Relevant literature is discussed, and the suggestion is made that, whilst an ACL rupture may be the most commonly noted soft tissue component associated with a Segond fracture, the clinician should have a high level of suspicion for other serious soft tissue injuries. Level of evidence V.

A stress fracture can be defined as a fracture of a bone caused by repeated (rather than sudden) mechanical stress. They have been reported in almost all bones of the body, with the lower extremity weight bearing bones, especially the tibia, tarsals and metatarsals, being affected most often. These injuries have a broad spectrum of severity and prognosis. Although the pathology of this injury is understood, the aetiology is less agreed upon. This can make it difficult for clinicians to diagnose and treat this common injury. Stress fractures of the proximal tibiae are common in elderly patients with osteoarthritis, and they are also reported in children. Here, we report an unusual case of an otherwise fit, young, adult male who presented with bilateral insufficiency stress fractures occurring simultaneously in both proximal tibiae. Stress fractures should be a differential diagnosis in any young, fit adult who presents with spontaneous knee pain.

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Acute pancreatitis is not an uncommon disease in an emergency department (ED). It manifests as upper abdominal pain, sometimes with radiation of pain to the back and flank region. Isolated left flank pain being the sole manifestation of acute pancreatitis is very rare and not previously identified in the literature. In this report, we present a case of acute pancreatitis presenting solely with left flank pain. Having negative findings on an ultrasound initially, she was misdiagnosed as having possible ''acute pyelonephritis or other renal diseases''. A second radiographic evaluation with computed tomography showed pancreatitis in the tail with abnormal fluid collected extending to the left peri-renal space. We performed a literature review and discussed this rare occurrence of acute pancreatitis. We also discussed the clinical pitfalls in this case.

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