Purpose or Case Report: Fractures in children and adolescents appear different on radiographs than fractures in adults. Pediatric fractures can be very subtle and difficult to detect if the radiologist is not actively looking for them, and a missed fracture can result in severe impairment in the future. The purpose of the presentation is to show the characteristic findings of frequently missed fractures in children.
Methods & Materials: A pictorial review of frequently missed fractures in children was performed by obtaining relevant cases and description from the picture archiving and communication system of an urban children’s hospital. A literature search on current information of the cases was performed. The presented cases include: Scaphoid fracture, buckle fracture of the humerus, tibial plateau fracture, non accidental spine fracture, skull fracture, non displaced supracondylar fracture, finger buckle fracture, pelvic fractures, slipped capital femoral epiphysis, toddler’s fracture and calcaneal fracture.
Results: Many fractures in infants, young children, and even adolescents can be subtle, and obtaining adequate clinical information to suggest the injury is frequently difficult. Often, there is difficulty in differentiating pathology from normal findings. Understanding these injuries and, actively looking for subtle findings are required to prevent missing a fracture.
Conclusions: Pediatric fractures can be very subtle and difficult to detect, in addition, the anatomic variations in bone contour and epiphyseal plate configuration may be easily confused with pathology. An accurate history and a good physical exam are required to understand the mechanism of injury, and a thorough search by the radiologist is necessary to detect the lesion.