After taking an X-ray after a fracture, why do we sometimes need to do a CT scan?

Doctors usually need to take X-rays to determine whether there is a fracture.

X-ray examination is the preferred examination method for initial screening of diseases. Its imaging is intuitive and clear. Whether it is observing the overall structure or evaluating the bone condition, it can quickly assist clinical physicians in making a diagnosis and has strong guiding significance. X-ray examination has the advantages of low price, fast examination, good overall imaging, and low radiation. However, because the images of tissues overlap, the evaluation of details is lacking and only very little soft tissue information can be provided.

Why do we need MRI after X-ray and CT scan?

To check the bone structure, why do we sometimes need to do CT scan in addition to X-ray?

For some patients, X-rays can initially determine that there are problems with the bone structure, but the details cannot be determined. CT can provide doctors with more diagnostic information. It can scan the overall structure layer by layer, and each section can form a corresponding image. We can then find the specific location of the lesion from multiple images.

Can't we see the structure clearly after X-rays and CT scans? Why do we need MRI (magnetic resonance imaging)?

For some patients with joint injuries or elderly spinal pain, MRI may be needed after X-ray or CT scans to understand the bone condition. MRI has a higher resolution for soft tissues than X-rays and CT scans, and can show cartilage, ligaments, meniscus, etc., and is more accurate than X-rays and CT scans in diagnosing bone marrow contusions, occult fractures, and fresh fractures.

Fracture healing is divided into four stages

So, how long after a fracture does it take to have an X-ray reexamination?

After a fracture occurs, doctors will recommend taking X-rays regularly to understand the effect of fracture treatment, such as whether the fracture is displaced again, the healing of the fracture, etc. So how often should we take X-rays? First of all, we need to understand the healing process of fractures.

There are four main stages of fracture healing:

1. Hematoma inflammation organization stage (about 2 weeks). When a bone breaks, blood vessels at the fracture rupture and form a hematoma, which helps control bleeding and provide cells and nutrients needed for healing. This stage is similar to a scab on a wound.

2. Initial callus formation period (4-8 weeks). The hematoma begins to transform into a soft tissue called cartilage, which gradually connects the two ends of the broken bone to form a soft "bridge". This stage is similar to using plasticine to temporarily fix a broken wooden stick.

3. Bone plate formation and shaping period (8-12 weeks). The cartilage is gradually replaced by harder bone tissue, forming the so-called hard callus. This is an important stage in fracture healing, and the bone regains strength. This process is similar to the gradual hardening of plasticine, eventually forming a solid connection.

4. Fracture remodeling period (1-2 years) The newly formed hard callus will be constantly remodeled to restore the original shape and function of the bone. This stage is similar to grinding and polishing a repaired wooden stick to restore it to its original shape. The remodeling period can last for several years, during which the bone will gradually become stronger.

Schedule of X-ray examinations

Purpose and timing of X-ray examinations after fractures:

1. Purpose of the initial X-ray examination

Doctors usually do an initial X-ray right after a fracture occurs. This confirms that a fracture is present and describes the type and location of the fracture. It also assesses the severity of the injury: This helps doctors determine the best treatment, such as whether reduction or surgery is needed.

2. Immediate X-ray examination after fracture reduction or surgery

After a fracture is reduced or treated surgically, doctors may take X-rays to make sure the bones are aligned correctly or to confirm that devices (such as plates or screws) that fix the bone are in place correctly.

3. Purpose and timing of follow-up X-ray examinations

The healing process after a fracture treatment requires regular X-rays to monitor the healing of the bone. These follow-up exams are usually done after: Initial healing assessment: Checks the early healing of the fracture site to make sure the bone is healing properly. Fixation device check: Confirms that the fixation device is still in place and has not moved or loosened.

Progress assessment is required after 3 months: Detailed assessment of the progress of bone healing and adjustment of treatment plan: Based on the healing situation, the doctor may adjust the rehabilitation plan or perform other necessary treatments.

4. Long-term follow-up examination

In some cases, especially complex fractures or fractures that heal slowly, your doctor may order more follow-up tests.

If no clear fracture is found in the X-ray after the injury, but there is a high suspicion of a fracture, the doctor will ask the patient to have a follow-up X-ray at a certain time. If a fracture is confirmed, regular follow-up is required. This is because the fracture process usually takes about two weeks, so if you take another X-ray after two weeks, you will find clearer signs of fracture or other occult fractures. In addition, for some unstable fractures, such as common distal radius fractures and tibia fractures, if conservative treatment is adopted, it is recommended to take a X-ray once a week if necessary to ensure timely detection of re-displacement and other conditions.

X-rays are an important part of ensuring that fractures heal properly. From initial diagnosis to follow-up exams, X-rays provide critical information at every stage to help doctors make the right treatment decisions. With regular X-rays, doctors can identify and address any potential problems in a timely manner, ensuring a smooth recovery for patients.

Lu Jianzuo, Chief Physician of Orthopedics Department of Wenzhou People's Hospital, Zhao Xizhen, Deputy Chief Nurse