Musculoskeletal radiographs, checklists, and common injuries
Musculoskeletal
General Description
Location
Proximal
Diaphyseal
Metaphyseal
Distal
Intra-articular
Configuration
Compound (open)
Simple (transverse, oblique, or spiral) Segmental
Comminuted
Avulsed
Impacted
Osteochondral
Torus (buckle)
Incomplete (greenstick)
Alignment
Displacement
Distraction
Override
Angulation
Shoulder
Radiographs
AP internal rotation
AP external rotation
Axillary and/or trans-scapular
Checklist
Scapula body
Acromion
Coracoid process
Clavicle
Humeral head
Glenohumeral, acromioclavicular, and coracoclavicular articulations
Common Injuries
Anterior dislocation
Posterior dislocation
Acromioclavicular separation
Clavicle fracture
Humeral head/neck fractures
Elbow
Radiographs
AP
Lateral
Angled oblique (Greenspan)
Checklist
Humerus
Ulna
Radius
Effusion (anterior and posterior fat pad signs)
Position and appearance of ossification centers (in children)
Radiocapitellar and anterior humeral line alignment (in children)
Common Injuries
Dislocation
Radial head fracture
Coronoid process fracture
Olecranon fracture
Humeral supracondylar fracture Humeral epicondylar avulsion
Hand and Wrist
Radiographs
AP
Lateral
Oblique
Scaphoid (wrist)
Checklist
Soft tissues
Distal radius and ulna
Carpal bones
Metacarpals
Phalanges
Carpal arch alignment (AP)
Lunate-capitate alignment (lateral)
Common Injuries
Distal radius/ulnar styloid fracture
Scaphoid fracture
Lunate and perilunate dislocation
Triquetral fracture
Metacarpal fracture
Dorsal and volar plate avulsion fractures
Amputations and transections
Pelvis
Radiographs
AP
Bilateral oblique (Judet)
Inlet and outlet
Checklist
Pubic rami, pubic symphysis, and ischial tuberosities
Iliac bones
Sacral alae and sacroiliac articulations
Lower lumbar vertebrae/transverse processes
Acetabula
Femoral heads and necks
Pelvic soft tissues
Common Injuries
Lateral compression fracture
Anterior-posterior compression fracture/open-book fracture
Windswept pelvis
Vertical shear fracture
Pubic rami fractures
Acetabular fracture
Hip
Radiographs
AP
Cross-table lateral
Frog-leg lateral
Checklist
Pubic rami, pubic symphysis, and ischial tuberosities
Iliac bones
Sacral alae and sacroiliac articulations
Acetabulum
Femoral head and neck
Common Injuries
Subcapital, transcervical, and basicervical femoral neck fracture
Intertrochanteric or subtrochanteric fracture
Greater or lesser trochanter avulsion
Dislocation
Pubic ramus fracture
Acetabular fracture
Slipped capital femoral epiphysis (children)
Knee
Radiographs
AP
Lateral
Cross-table lateral (in trauma)
Oblique
Patellar (sunrise)
Checklist
Soft tissues
Effusion or lipohemarthrosis
Patella
Quadriceps and patellar tendons
Femoral condyles
Tibial plateau and spines
Fibular head
Common Injuries
Patellar fracture
Quadriceps or patellar tendon rupture
Anterior cruciate ligament injury (look for lateral condylar notch sign)
Tibial plateau fracture
Tibial spine avulsion
Segond fracture (lateral tibial plateau avulsion; associated with ACL tear)
Proximal fibular avulsion fracture (arcuate sign, associated with posterolateral ligamentous injury)
Ankle and Foot
Radiographs
AP
Lateral
Oblique
Calcaneus
Checklist
Soft tissues
Distal fibula
Medial tibial malleolus
Cortex of distal tibia and talar dome (look for osteochondral fractures)
Posterior tibia (lateral view)
Tibiotalar interval and ankle mortise congruence
Talus
Calcaneus and midfoot (navicular, cuboid, cuneiforms)
Base of fifth metatarsal
Alignment of metatarsals with respect
to cuneiformsMetatarsal shafts (stress fractures)
Phalanges
Common Injuries
Rotational ankle injuries (distal fibular, bimalleolar, and trimalleolar fractures)
Axial load (pilon) fractures of the distal tibia
Salter Harris fractures in children and adolescents (triplane fracture, Tillaux fracture)
Calcaneal fractures
Lisfranc fracture dislocations
Metatarsal stress fractures
Fifth metatarsal fractures (Jones, Pseudo-Jones)
Phalynx fractures.