How do you distinguish between a buckle fracture and a bruised bone on an x-ray?

Look for fracture: A buckle fracture is a minor fracture, but it will be visible on an X-ray. A bone bruise is really more of a clinical disgnosis in which the X-ray will be normal but a contusion was felt to have occurred based on mechanism of injury and exam. MRI will show a bone contusion but not an X-ray, but we usually don't get an MRI for them because it does not really change the management.

Very similar: A buckle fracture and a bruised bone are very similar to each other - One could say they are two ways of describing an injury to bone that is not associated with much displacement. Treatment should be immobilization on until healed.