Figures 18-20. (18) Knee fracture in a patient with a history of a gunshot wound. Anterior (a) and lateral (b) volume-rendered spiral CT images show a comminuted fracture of the distal femur (arrow). (19) Anterior (a) and lateral (b) volume-rendered spiral CT images clearly show a comminuted fracture of the tibial plateau (arrow). Because of the presence of a partial cast, the examination would have been extremely limited if performed with plain radiography. (20) Knee fracture in a 12-year-old boy who hit a stationary automobile while riding a moped. Anterior (a) and posterior (b) volume-rendered spiral CT images show a fracture of the lateral aspect of the distal femur (arrow in a). Avulsion of the tibial spines is best seen on the posterior view (arrow in b).