School ager with ankle pain after a trampoline injury

Radiograph of non-displaced Salter Harris fracture Type I of distal fibula — AP (left) and oblique (right) radiographs of the ankle show a large amount of soft tissue swelling with its apex over the fibular physis. There is a transverse lucent line through the epiphysis of the fibula.

The diagnosis was a non-displaced Salter-Harris fracture Type I of the distal fibula along with a fracture of the epiphysis of the fibula.

Teenager after a motor vehicle accident

Radiograph of a pelvis apophyseal avulsion fracture of the right anterior superior iliac spine and a pelvis fracture of the right iliac crest — AP radiograph of the pelvis shows an apophyseal avulsion fracture of the right anterior superior iliac spine and a laterally displaced fracture of the right iliac crest.

The diagnosis was a pelvis apophyseal avulsion fracture of the right anterior superior iliac spine and a pelvis fracture of the right iliac crest.

Preschooler with unusual appearing feet

Radiograph of amniotic band syndrome of the feet — AP radiograph of the feet shows in the left foot there is amputation of most of the phalanges while in the right foot there is amputation of most of the first distal phalanx and the second middle and distal phalanges.

The diagnosis was amniotic band syndrome causing amputation of the phalanges of the feet.

Teenager with a painful, red, axillary mass.

US of subcutaneous abscess — Transverse US of the axilla centered on the palpable mass shows an oval hypoechoic lesion in the subcutaneous tissue.

The diagnosis was subcutaneous abscess.

School ager who has arm pain after fall on arm

Radiograph of greenstick fracture of radius — AP (left) and lateral (right) radiographs of the forearm show a faint jagged lucency affecting one cortical surface at the diaphysis of the radius with mild angulation of the fracture fragments.

The diagnosis was greenstick fracture of the radius.

Infant exposed to a sexually transmitted disease in utero

Radiograph of syphilis osteomyelitis — AP radiograph of the lower extremities shows diffuse periosteal reaction and cortical thickening and bowing of the bilateral femora and tibae and fibulae.

The diagnosis was chronic osteomyelitis due to syphilis.

Teenager who hit the side of his foot on a door and now has pain in the proximal fifth metatarsal

Radiograph of fifth metatarsal fracture — AP (left) and oblique (right) radiographs of the foot show a transverse linear lucency through the base of the fifth metatarsal.

The diagnosis was fracture of the fifth metatarsal.

Newborn with respiratory distress

CXR of short rib polydactaly syndrome — CXR AP (left) and lateral (center) show extremely short ribs resulting in a very small thorax and thus low lung volumes. AP radiograph of the upper extremity (right) shows a short humerus and an extra digit attached to the fifth digit.

The diagnosis was short rib polydactyly syndrome with post axial polydactyly.

Toddler with elbow pain after fall on outstretched hand

Radiograph of supracondylar elbow fracture — AP radiograph of the elbow (left) shows a supracondylar fracture line in the humerus. Lateral radiograph (right) shows the anterior humeral line does not intersect the capitellum.

The diagnosis was supracondylar elbow fracture.

School ager with hand pain after trauma

Radiograph of melorheostosis — AP and oblique radiographs of the hand show a flame-shaped sclerotic lesion in the proximal aspect of the third metacarpal.

The diagnosis was melorheostosis.

School ager with forearm pain after fall

Radiograph of Monteggia fracture dislocation — AP (left) and lateral (right) radiographs of the forearm show a fracture of proximal ulna, disruption of radioulnar joint, and dislocation of the radial head.

The diagnosis was Monteggia fracture dislocation.

School ager with left groin pain

Radiograph of ischiopubic synchondrosis asymmetry — AP radiograph of the pelvis shows a normally fused right ischiopubic synchrondrosis while the left ischiopubic synchondrosis is asymmetrically enlarged in appearance.

The diagnosis was ischiopubic synchondrois asymmetry on the left side.

Toddler with developmental delay who had a seizure and fell on the floor

Head CT of hypoparathyroidism and cavum septum pellucidum and cavum vergae — Axial (above) and coronal (below) CT without contrast of the brain shows multiple bilateral calcifications in the subcortical white matter. There are additional CSF spaces present between the leaflets of the septum pellucidum and anterior to the splenium of the corpus callosum.

The diagnosis was hypoparathyroidism in a patient with cavum septum pellucidum and cavum vergae.

Teenager with neurofibromatosis type I and knee pain

Radiograph of multiple non ossifying fibromas in Jaffe Campanacci Syndrome — AP and lateral radiographs of the knee show multiple lucent lesions with thin sclerotic margins in the metaphysis of the femur, tibia and fibula.

The diagnosis was multiple non ossifying fibromas in Jaffe Campanacci Syndrome in a patient with neurofibromatosis type I.

School ager with ankle pain after a fall

Radiograph of triplane fracture of the ankle — AP (left), lateral (center) and oblique (right) radiographs of the ankle show a fracture line that is in the sagittal plane on AP view and in the axial and coronal planes on the lateral view.

The diagnosis was triplane fracture.

Preschooler with a limp

Radiograph of growth arrest lines in the long bones — AP radiograph of the lower extremity shows two dense fine lines in the proximal metaphysis of the femur, and in the proximal and distal metaphyses of the tibia and fibula.

The diagnosis was growth arrest lines.

Teenager who stepped on a pencil in their bare feet

Radiograph of pencil tip in the subcutaneous soft tissues of the foot — Lateral radiograph of the ankle shows a faintly radiopaque pointed object in the heel of the foot as indicated by the arrow.

The diagnosis was a foreign body in the soft tissues of the heel in the form of a pencil tip.

Newborn who experienced shoulder dystocia during delivery and now has pain when the left arm is moved

Radiograph of humerus fracture — AP radiograph of the upper extremity shows a fracture line through the diaphysis of the humerus. The fracture fragments are not in anatomic alignment and apposition.

The diagnosis was fracture of the proximal humerus.

Teenager who hurt their knee playing football

Radiograph of tibial plateau fracture — AP radiograph of the knee (left) shows a linear lucency associated with the medial aspect of the proximal metaphysis. Lateral radiograph (right) shows a linear lucency associated with the posterior aspect of the metaphysis.

The diagnosis was tibial plateau fracture.

School ager with leg pain

Radiograph of stress fracture of proximal tibia — AP (left) and lateral (right) radiographs of the tibia and fibula show a double density in the tibial metaphysis which has periosteal reaction associated with it medially and posteriorly.

The diagnosis was stress fracture of the proximal tibia.

Teenager with leukemia and pancytopenia and knee pain

MRI of avascular necrosis of knee — Sagittal T1 (left) and STIR (right) MRI without contrast of the knee show a large knee joint effusion along with well demarcated serpiginous lesions in the distal femur and proximal tibia that on STIR images demonstrate the double line sign.

The diagnosis was avascular necrosis of the knee.

Infant with hepatosplenomegaly, jaundice, and a maculopapular rash

Radiograph of syphilis of long bones — AP radiograph of the knee at presentation (left) shows faint periostitis of the distal femur and proximal tibia and fibula. There is a metaphyseal lucency present along the proximal portion of the medial aspect of the tibial metaphysis (Wimberger corner sign). Repeat radiograph obtained 2 months later while on therapy (right) shows dense periostitis of the bones with resolution of the lesion previously seen on the proximal medial tibial metaphysis.

The diagnosis was syphilis.

Teenager with right wrist pain after trauma

Radiograph of scaphoid fracture — AP radiograph of the wrist (left) shows a double density over the scaphoid bone. Scaphoid view (right) shows a lucency through the waist of the scaphoid bone with displacement of the fracture fragments.

The diagnosis was scaphoid fracture.

Preschooler with left hip pain

Radiograph of Meyer dysplasia — AP radiograph of the hips shows a normal appearing left hip. There is flattening and sclerosis of the right femoral epiphysis which may have multiple ossification centers and there is also right metaphyseal subcortical cystic change.

The diagnosis was Meyer dysplasia.

Teenager who jammed their finger in a door

Radiograph of Salter Harris Type III phalanx fracture — Lateral radiograph of the hand shows a fracture line through the physis and extending into the epiphysis of the fourth middle phalanx. There is a fracture fragment displaced dorsally.

The diagnosis was Salter Harris Type III fracture of the fourth middle phalanx.