Of fracturerequest

Scaphoid

Calcaneus

'X-ray wrist. ? fracture"

Fractures of the scaphoid are difficult to visualise: a minimum of 3 specialised views is required. A fracture may not show on the standard wrist projections

A tangential projection, with or without an additional oblique (along with the usual lateral), is necessary for satisfactory visualisation of the calcaneus. These views arc not taken routinely when an X-ray examination of the foot or ankle is called for

'X-ray calcaneus. 7 fracture"

Neck of femur

'X-ray femur. ? fracture"

Poor centring of the radiographs may render the fracture invisible

'X-ray hip, ? fracture neck of femur' or 'X-ray to exclude fracture of femoral neck'

Tibial table or tibial spines

'X-ray tibia. ? fracture"

Poor centring may render the fracture invisible, or the area may not be included on the film

"X-ray upper third tibia to exclude fracture of tibial table'

14. The standard projections: These are an anteroposterior (AP) and lateral. Ideally the beam should be centred over the area of suspected fracture, with visualisation of the proximal and distal joints. This is especially important in the paired long bones where, e.g.. a fracture of the tibia at one level may be accompanied by a fibular fracture at another.

15. Comparison films: Whea- there is some difficulty in interpreting the radiographs (e.g. in the elbow region in children, where the epiphyseal structures are continually changing, or where there is some unexplained shadow or a congenital abnormality) films of the other side should betaken for direct comparison.

16. Oblique projections: In the case of the hand and foot, an oblique projection may be helpful when the lateral gives rise to confusion due to the superimposition of many structures. Such oblique projections may have to be specifically requested when they are not part of an X-ray department's routine.

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