While radiographs remain the foundation for evaluating osseous trauma, cross-sectional imaging plays an increasingly important role, particularly in the assessment of spinal injuries. This article reviews key aspects of cervical and thoracolumbar trauma, highlighting fracture patterns, mechanisms, classification systems, and their implications for stability and management. In the extremities, we have emphasized coracoid fractures, proximal humeral and femoral neck fractures, and tibial plateau fractures, illustrating the importance of accurate characterization of fracture morphology. By integrating meticulous imaging assessment with structured classification frameworks, radiologists play a central role in guiding evidence-based management and optimizing functional outcomes in patients with musculoskeletal trauma.