What is a "possible fracture"?

A patient asked me recently what it meant when a report from an x-ray read "possible fracture"? Often when a patient sustains a fracture, also called a broken bone, it is easily visible on x-ray. However, sometimes the crack in the bone is not separated, and cannot be seen. But there can be other signs of a fracture seen on an x-ray, including:

• Evidence of healing bone (periosteal reaction)

• Excess bone formation (fracture callus/cortical hypertrophy)

• Soft-tissue swelling

• Excess joint fluid

All of these signs indicate some process is taking place, and it is possible that a fracture could cause these x-ray findings. If the injury and examination are consistent with a fracture, then the injury may be treated as such, even though the fracture is not visible. That is why the radiologist says there may be a "possible fracture."

Related: Difference between a fracture and a break? | Types of Broken Bones