Advanced Trauma Life Support (ATLS) Practice Exam

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What imaging should be performed for any tender or painful extremities?

  1. CT of the head

  2. X-ray

  3. Ultrasound of the abdomen

  4. MRI of the joints

The correct answer is: X-ray

When evaluating tender or painful extremities, the appropriate imaging modality is X-ray. X-rays are the first-line imaging technique used in trauma assessments because they are quick, widely available, and effective at identifying fractures, dislocations, and other bony abnormalities. Given that extremity pain often arises from injuries to bones, detecting an acute fracture or joint displacement is crucial for guiding initial treatment. While other imaging techniques like MRI can provide more detailed images of soft tissues, cartilage, ligaments, and muscles, they are typically reserved for cases where more information is needed beyond what an X-ray can provide, or if there is suspicion of soft tissue injury. CT scans, while excellent for complex fractures, are not routinely used for initial evaluations of painful extremities, particularly in cases where simple fractures can be easily identified with X-rays. Ultrasound is generally not indicated for initial assessment of extremity pain unless there is a specific concern for soft tissue abnormalities such as tendon injuries or effusions. Thus, X-ray stands out as the most appropriate and efficient initial imaging choice for assessing tender or painful extremities.