These cases are intended to be used as education materials. There are intentionally no answers. The objective is to provide teaching and test cases where the radiographers cannot "look up the answers on the Internet ". This case can be answered at different levels from student radiographer to advanced radiographer practitioner or reporting radiographer.

This case is suitable for all levels of radiographers from 1st year students to reporting radiographers. The answers will clearly be different for different levels.

This is a 16 year old boy who has presented to the Emergency Department. He has been referred for ankle radiography with the following clinical information

"? avulsion # left ankle"

	Is there evidence of bony injury on this image? Is there soft tissue evidence of injury? Comment on any artifacts and non-acute findings

	Is there evidence of fracture? Are there any soft tissue signs of injury? If there is evidence of bony injury- can you be sure which bone is fractured? If not, what are you going to do?

	The radiographer has deliberately performed a poorly positioned lateral ankle- why? Is this image helpful?