1. Introduction
Plain film interpretation is a core clinical skill. A systematic approach helps you identify fractures, dislocations and associated soft tissue injury and ensures you describe the abnormality clearly.
2. Initial checks
Confirm the patient details, date and time, side marker and imaging modality. Ensure the correct body part is shown and assess image adequacy, including view, positioning, exposure and whether there are at least two orthogonal views when appropriate.
3. Systematic review
Use a structured method such as ABCS. Review alignment, bone cortex and trabeculae, joint spaces or cartilage, and soft tissues. Trace the cortex of each bone completely and look for subtle lucencies, buckling, cortical step or periosteal disruption.
4. Describe the injury
If a fracture is present, describe the bone, side, exact anatomical location, whether it is intra articular, the fracture pattern, degree of displacement, angulation, shortening or rotation, and whether there is comminution or an associated dislocation.
5. Associated injuries and summary
Actively look for joint dislocation, neurovascular risk, soft tissue swelling, lipohaemarthrosis and injuries commonly associated with the fracture pattern. Finish with a concise one sentence summary and suggest immediate management priorities.
Initial checks
Systematic review
Fracture description
Associated injuries
Summary