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The sensitivity of conventional radiography in acute knee trauma

A 23-year-old man presented to the emergency department because of pain and swelling of the left knee after a motorcycle accident that had occurred the day before. Clinical examination suggested the presence of joint effusion in the suprapatellar pouch, with severe pain in the affected knee. A plain radiograph of the knee showed no signs of fracture. Computed tomography (CT) of the left knee revealed an oblique fracture of the tibial plateau. As the treating clinician, you question the sensitivity of plain x-rays to identify fractures in the knee.