Change: mounainmountain peaks faintly visible through mist. If this sign is not recognised , patients with tibial metaphysis fractures can have their fractures missed. Radiographers who are able to recognise this sign will be able to perform the necessary supplementary projection imaging required at the time of the acute presentation.   View changes from previous version. (Word count: 1359)

Change: projection imaging requieredrequired at the time of the acute presentation. The Positioning TrapA poorly positioned lateral ankle can either hide a posterior malleolus fracture or reveal a posterior malleolus fracture. The following case studies demonstrate both types of cases Case 1This patient presented to   View changes from previous version. (Word count: 1351)

Change:  Radiographers who are able to recognise this sign will be able to perform the necessary supplementary projectiosn requiered at the time of the acute presentation. The Positioning TrapA poorly positioned lateral ankle can either hide a posterior malleolus   View changes from previous version. (Word count: 1346)

Change:  The mountain peak sign can be seen in any AP (ish) ankle projection of coronal plane distal tibial fractures... they are no always posterior malleolus fractures DiscussionPosterior malleolus fractures of the distal tibia are easily missed, particularly when   View changes from previous version. (Word count: 1261)

Change: This patient presented to the Emergency Department with a painful and swollen ankle. The mechanism of injury was unknown. The referring doctor requested an ankle x-ray examination to rule out any bony injury.Patient History This patient presented to the Emergency Department with a painful and swollen right ankle.   View changes from previous version. (Word count: 920)

Change: This patient has soft tissue swelling over the lateral malleolus. This is likely to be associated with a ligamentous injury- the bony injury is to the distal tibial metaphysis.2. Ankle Effusion- The Teardrop Sign An ankle effusion suggests a significant injury   View changes from previous version. (Word count: 959)

Change: botheither hide a posterior mallelusmalleolus fracture or reveal a posterior malleolus fracture. The following case studies demonstrate both types of cases Case 1Patient History This patient presented to the Emergency Department with a painful and   View changes from previous version. (Word count: 959)

Change: Twisted right ankle. Not weight-bearing ImagesThe AP ankle image demonstrates soft tissue thickening laterally. There is no evidence of an associated displaced fracture of the fibulaThe oblique ankle image demonstrates no displaced fracturesThe lateral ankle image demonstrates the followingankle effusion (lower white arrow)abnormal Kager's   View changes from previous version. (Word count: 959)

Change:  was performed by a newly graduated radiographer. The level of proficiency demonstrated in this case is achievable by junior radiographic staff.... back to the Applied Radiography home page   View changes from previous version. (Word count: 949)

Change: under-rotatedover-rotated lateral position demonstrates a minimally displaced fracture of the posterior malleolus. Interestingly, this a very similar position to that which failed to demonstrate the posterior malleolus in case 1 and case 2.It is noteworthy that when the radiographer returned   View changes from previous version. (Word count: 937)