An uncommon fracture can be easy to miss, and if you do not look for it, you might not see it.
Scapula fractures – Typically seen in association with other injuries in setting of major trauma, but may be missed in the patient with shoulder pain 2/2 lower impact trauma. Most isolated scapular fractures can be treated conservatively with pain medications and short-term use of a sling.
Acromion fractures – Also seen in setting of major/high-energy trauma, and typically with other associated shoulder injuries. Displaced fractures and fractures with other significant shoulder lesions may require surgery.
Triquetrum fractures – 2nd most common carpal fracture (scaphoid is first) and account for approx. 15% of carpal fractures. Triquetral body fractures with displacement > 1 mm should be referred to a hand surgeon.
Tyson S, Hatem SF. Easily Missed Fractures of the Upper Extremity. Radiol Clin North Am 2015; 53(4):717-36.