Teenager who fell and twisted their foot and now has pain at the base of the fifth metatarsal

Radiograph of 5th proximal metatarsal fracture (Jone's fracture) — AP radiograph of the foot shows a transverse lucency through the base of the fifth metatarsal.

The diagnosis was a fifth metatarsal fracture.

School ager with right hip pain after a motor vehicle accident

Radiograph of posterior hip dislocation — AP radiograph of the pelvis (on a trauma board) shows the right femoral head to be dislocated posteriorly.

The diagnosis was right traumatic posterior hip dislocation. There are no fractures.

Teenager with severe left hip pain

Radiograph of slipped capital femoral epiphysis — AP radiograph of the pelvis (left) and AP radiograph of the left hip (right) shows left femoral head physeal widening, with the femoral head slipping posteromedially as evidenced by the line of Klein drawn over lateral aspect of femoral neck not intersecting any of the femoral head.

The diagnosis was left slipped capital femoral epiphysis.

School ager who fell off their bike

Radiograph of Monteggia fracture dislocation — AP radiograph of the forearm shows a fracture of the proximal ulna, disruption of radioulnar joint, and radial head dislocation as the radial shaft line does not align / intersect with the capitellum.

The diagnosis was Monteggia fracture dislocation.

School ager who fell off the monkey bars and now has elbow pain

Radiograph of radial neck elbow fracture — Lateral radiograph of the elbow (left) shows elevation of the anterior and posterior fat pads due to a joint effusion and an abnormal orientation of the radial head. AP radiograph of the elbow (right) shows a complete fracture through the radial neck.

The diagnosis was radial neck elbow fracture.

Teenager with left midfoot pain after a diving board accident

Radiograph of LisFranc fracture dislocation — AP radiograph of the feet shows widening at the base between the left first and second metatarsals.

The diagnosis was left LisFranc fracture dislocation.

Preschooler with short stature

MRI of spinal stenosis in achondroplasia — Sagittal T2 MRI of the spine shows a very narrow spinal canal with only a small amount of cerebrospinal fluid present anteriorly and posteriorly to the spinal cord, especially at the skull base. There is mild scalloping of the posterior aspect of the vertebral bodies.

The diagnosis was achondroplasia causing spinal stenosis.

Teenager who fell off his bike

Radiograph of clavicle fracture — AP (left) and oblique (right) radiographs of the clavicle show multiple lucent lines through the distal clavicle.

The diagnosis was a comminuted distal clavicle fracture.

School ager with progressive back pain

CT and MR of vertebra plan in Langerhans cell histiocytosis — Sagittal CT without contrast of the spine (far left) shows a marked compression deformity of the T7 vertebral body which is almost flat in appearance. Sagittal T2 MRI of the spine (near left) shows again loss of height in the T7 vertebral body with the T6-T7 and T7-T8 intervertebral disks in close approximation to each other. There is evidence of a high signal intensity soft tissue mass anterior and posterior to the T7 vertebral body. Sagital T1 MRI of the spine without (near right) and with contrast (far right) show enhancement of this soft tissue mass anterior and posterior to T7 which has an extradural component which is compressing the spinal cord at this level.

The diagnosis was vertebra plana of the T7 vertebral body due to Langerhans cell histiocytosis.

School ager injured in an accident inside a grain silo

Radiograph of bowing fractures of the tibia and fibula — AP radiograph of the right femur (left) shows a complete fracture of the femur. AP radiograph of the right tibia and fibula (right) shows the tibia and fibula to be bowed in appearance.

The diagnosis was bowing fractures of the tibia and fibula and complete fracture of the femur.

Teenager with proximal muscle weakness and a heliotrope rash

MRI of dermatomyositis — Coronal (above) and axial (below left) T2 MRI of the pelvis along with axial T2 MRI of the thighs (below right) shows diffuse, bilateral, symmetrical bright signal in the visualized muscles representing intramuscular edema in the quadratus lumborum, gluteal, and proximal thigh hamstring muscles.

The diagnosis was dermatomyositis.

Teenager who while wrestling heard a popping noise and now has right sided sternal pain

3D CT of posterior sternoclavicular joint dislocation — CT 3D reconstruction without contrast of the sternoclavicular joints viewed from anteriorly (above) and from underneath (below) shows widening of the right sternoclavicular joint space when compared to the left sternoclavicular joint space. The right clavicular head is also displaced posteriorly when compared to the left sternoclavicular head.

The diagnosis was right posterior sternoclavicular joint dislocation.

Teenager with ankle pain after being tackled

CT of a triplane fracture of the ankle — Coronal (left) and sagittal (right) CT 2D reconstructions without contrast of the ankle show a sagittal fracture through the tibial epiphysis, an axial fracture through the physis, and a coronal fracture through the tibial metaphysis.

The diagnosis was a triplane fracture of the ankle (Salter Harris Type IV fracture).

Toddler with a palpable bump on the back of the head just to the left of midline

MRI of soft tissue hemangioma of the scalp — Axial T2 MRI without contrast of the brain (above) shows a well defined lesion in the subcutaneous tissues just to the left of midline that has heterogenous signal intensity. The lesion shows primarily low signal intensity on axial T1 MRI without contrast (below left) and enhances markedly and fairly uniformly on axial T1 MRI with contrast and fat saturation (below right).

The diagnosis was soft tissue hemangioma.

Toddler with knee pain after bouncing on a trampoline

Radiograph of trampoline fracture — AP (left) and lateral (right) radiographs of the knee show a transverse lucency extending throughout the proximal tibial metaphysis.

The diagnosis was trampoline fracture.

Preschooler with a palpable bump in the midline of their back

US and MRI of soft tissue hemangioma — Transverse color and spectral US of the palpable lesion (above left) shows a discrete well circumscribed soft tissue mass with markedly increased vascularity. Axial T1 MRI without contrast of the spine (below left) shows the palpable mass to be in the subcutaneous tissues and to have low signal intensity, while on the axial T2 MRI (above right) the mass has high signal intensity. Axial T1 MRI with contrast and fat supression (below right) shows the mass to enhance markedly and uniformly.

The diagnosis was soft tissue hemangioma.

Infant with a right eyebrow mass

US of soft tissue hemangioma — Sagittal grayscale US of the right eyebrow (above) shows a solid homogenous soft tissue mass in the subcutaneous tissue that has marked vascularity on color doppler US (below).

The diagnosis was soft tissue hemangioma.

School ager on a bike hit by a car

CT of iliac wing fracture — Axial CT with contrast of the pelvis shows a buckling of the right iliac wing.

The diagnosis was right iliac wing fracture of the pelvis.

School ager with a swollen knee

Radiograph of knee joint effusion — Lateral radiograph of the knee shows a large amount of fluid in the suprapatellar recess that separates the periarticular fat pads >10 mm, obliterates the posterior border of the quadriceps tendon, and displaces the quadriceps tendon and patella anteriorly.

The diagnosis was knee joint effusion of unknown etiology.

Teenager who has had a nail gun injury to the hand

Radiograph of mallet finger fracture — Lateral radiograph shows an intra-articular fracture involving the dorsal aspect of the base of the distal third phalanx.

The diagnosis was mallet finger fracture.

Teenager with pain in the fifth metatarsal after a fall

Radiograph of 5th metatarsal fracture — AP (left) and oblique (right) radiographs of the left foot show a transverse lucency through the base of the fifth metatarsal.

The diagnosis was fifth metatarsal fracture.

Infant with an unexplained death undergoing post-mortem imaging

Radiograph of physiologic periosteal reaction — AP radiograph of the lower extremities shows faint symmetrical periosteal reaction in the diaphyseal region of the tibas bilaterally.

The diagnosis was physiologic periosteal reaction.

Teenager who fell on their right knee and has pain

Radiograph of lateral patellar dislocation — AP (above) and Merchant (below left) radiographs of the right knee show lateral displacement of the patella and a small avulsion fragment (sliver sign) medial to the patella. Merchant radiograph of the right knee post reduction (below right) shows appropriate reduction of the patella along with medial soft tissue swelling.

The diagnosis was lateral patellar dislocation.

Teenager with blunt trauma to the chest from a motor vehicle accident

Radiograph of sternal fracture — Lateral radiograph of the sternum shows a lucent cortical breach with depression of the anterior aspect of the first segment of the sternal body.

The diagnosis was sternum fracture.

Teenager with wrist pain

Radiograph of partial carpal coalition of lunate and triquetrum — AP radiograph of the wrist shows partial fusion of the proximal aspects of the lunate and triquetrum.

The diagnosis was partial carpal coalition of the proximal aspects of the lunate and triquetrum.