Imaging Evaluation of Pediatric Extremity Trauma,Part III: Lower Extremity and Soft Tissues

Lower extremity injuries are slightly less common than upper extremity injuries in children, and the structures below the knee are more often involved. Impaction injuries are often associated with twisting forces which can result in subtle buckle and hairline types of fractures, particularly in young children. Epiphyseal-metaphyseal injuries are especially common at the ankle. A variety of avulsion fractures also occur in the lower extremities, often associated with injury to nearby cartilaginous and ligamentous structures. This article reviews the important plain radiograph findings of lower extremity injuries in children as well as indications for special imaging such as ultrasound and MRI.