Easily missed trauma of bones and ligaments

While most fractures and dislocations are easily detected by radiographic and physical examination, some traumatic events are overlooked because the normal radiographic anatomy is not appreciated. Furthermore, certain routine radiographic views are inadequate to detect specific injuries. "Chip" or "sprain" fractures are often considered minor injuries when they actually connote significant injury to ligaments and capsules. These injuries are usually dismissed by the primary care physician, who does not believe them serious enough to warrant consulting an orthopedic surgeon. However, some are also overlooked by radiologists and orthopedic surgeons. If these injuries are not treated adequately, permanent loss of function or death may result. With these thoughts in mind, we will describe some of these injuries and discuss the radiographic anatomy, the knowledge of which should preclude some of the serious mistakes of diagnosis.