2 - Lower Extremity Plain Radiography

Summary

INDICATIONS

Lower extremity injuries are frequently encountered in ED and urgent care settings. As part of the workup of these patients, some type of imaging modality is frequently used. Plain radiography, being readily available, inexpensive, and having few contraindications, is frequently a starting point.

Plain radiography is useful in a number of clinical situations, including diagnosis of fractures and dislocations and evaluation of the end result after closed reductions performed in the ED. In addition, it is helpful in evaluating for radiopaque foreign bodies and assessing joint spaces for evidence of autoimmune or degenerative processes such as rheumatoid arthritis or avascular necrosis. Finally, plain films are also helpful in evaluation of possible infections, including those involving the bone itself, as in osteomyelitis, or of the adjacent soft tissues, as in necrotizing soft tissue infections.

DIAGNOSTIC CAPABILITIES

Lower extremity radiography is useful for the diagnosis of fractures and dislocations of the hip, knee, foot, and ankle, as well as demonstrating pathology of the femur, tibia, and fibula. Plain radiography is helpful in evaluating fractures of the lower extremity bones, as well as masses and malignancies, including pathological fractures. In some cases, these films will be supplemented with CT imaging of the affected area to provide additional information.