CHAPTER 39
Imaging Fractures
• Radiography is the imaging study of choice for pediatric fractures and should be performed first and before any advanced imaging study.
• For long bone injuries, obtain at least 2 views taken at 90 degrees to each other and include the joint above and below the site of pain to evaluate for any associated fractures or dislocations (Table 39-1).
• Include clinical information on the requisition, such as patient age, location of pain, and mechanism of injury to assist the radiologist in interpretation.
• Variants of normal anatomy are common. Keats and Anderson’s Atlas of Normal Roentgen Variants That May Simulate Disease can help differentiate an injury from one of these variants.
Table 39-1. Common Radiographic Series to Evaluate Fractures
| Anatomic Area | Series |
|---|---|
| Cervical spine | AP/lateral/odontoid |
| Thoracic spine | AP/lateral |
| Lumbar spine | AP/lateral/spot L5-S1 |
| Clavicle | AP/cephalic tilt |





