Which imaging modality is typically first-line for suspected bone fractures?

• A. Ultrasound
• B. Plain radiography (X-ray)
• C. MRI
• D. CT

Answer: (B)

When a bone fracture is suspected, plain radiography is used first because it is fast, widely available, and cost-effective. It provides clear images of the bone cortex, fracture lines, displacement, and joint alignment, helping determine if a fracture is present and guiding immediate management. If the X-ray shows a fracture, the images help plan immobilization or reduction and identify whether further imaging is needed for complex injuries. However, some subtle or occult fractures may not be visible on an initial X-ray, especially early after injury or in children with growing bones; in those cases, MRI or CT (or ultrasound in select scenarios) can be used to clarify the diagnosis. The other modalities are valuable for specific situations, but they are not typically the first-line test for suspected fractures.