Which radiographic feature distinguishes a fracture from a bone contusion?

• A. Contusion shows cortical disruption; fracture shows deep tissue swelling
• B. Fracture shows cortical disruption or displacement; contusion shows deep tissue swelling without cortical break
• C. Both show cortical breaks
• D. Contusion shows a visible bone fragment

Answer: (B)

The key idea is that fractures disrupt the bone’s cortex, often with displacement, while a bone contusion does not break the cortex and may show soft tissue swelling or edema. On radiographs, a fracture appears as a break in the continuity of the cortical bone and may involve misalignment or displacement of the bone fragments. A bone contusion, being an internal bruise, leaves the cortex intact; plain X-rays may be normal or show only soft tissue swelling, not a cortical break. That’s why the correct description is that a fracture shows cortical disruption or displacement, whereas a contusion shows deep tissue swelling without a cortical break. The other statements misstate these features—contusions do not typically show cortical disruption, bone fragments aren’t a hallmark of contusion, and not both conditions necessarily involve cortical breaks.