Whether the history is motor vehicle accident, fall from monkey bars, or sports-related injury, musculoskeletal trauma is one of the most common reasons for emergency department visits. Knowledge of the developing bone anatomy and specific pediatric fractures leads to appropriate diagnosis and treatment.

Common Musculoskeletal Trauma Imaging Techniques

Plain Radiographs

Multiorthogonal radiographs of the bones are a mainstay of trauma evaluation and are often the first line of evaluation.

Ultrasound

Ultrasound is often used in infants specifically for evaluation of cartilaginous portions of the bones. It is also used to assess for joint effusions, soft tissue lesions, or foreign body detection.

Computed Tomography

Complex fractures may necessitate additional evaluation by computed tomography (CT) to confirm/assess epiphyseal separation, comminution with fragments in the joint space, or the extent of fracture displacement or to determine for possible need of open reduction internal fixation. Contrast is occasionally used for evaluation of vascular injuries.

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is an excellent modality for evaluation of soft tissue and osseous injuries or bone marrow edema or to detect avascular necrosis. Contrast is typically not necessary unless infection or neoplasm is considered.

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