What it is (overview)

An XR Nasal Bones test is a plain X-ray (radiograph) focused on the small bones that form the bridge of the nose (the nasal bones). It is a common radiology exam used after a blow to the nose or face to look for a nasal bone fracture, bone displacement, or other bony abnormalities. During the exam, one or more images are taken from different angles so the radiologist can evaluate the alignment and shape of the nasal bones.

This test mainly assesses bone structure—it does not “measure” blood values or infection markers. It may also provide limited information about nearby structures (such as the upper part of the nasal cavity), but it is not a full evaluation of the sinuses. If sinus issues or deeper facial injuries are suspected, a CT scan may be recommended because it shows much more detail.

What the results usually mean:

A report may describe the nasal bones as normal (no visible fracture or deformity), show a fracture (a break in the bone), or note displacement (the broken bone pieces have shifted). The radiologist may also comment on swelling of nearby soft tissues, old/healed fractures, or other findings. A “normal” X-ray does not always fully rule out injury—some small fractures, cartilage damage, and septal injuries may not be clearly visible on X-ray, especially soon after trauma. Your clinician will interpret the imaging results together with your symptoms and physical exam.

When & why it's usually done

Doctors most often order an XR Nasal Bones exam after nasal trauma or facial injuries to help confirm whether the nasal bones are broken and whether the bones are out of alignment. The results can guide decisions about treatment, such as pain control, referral to ENT (ear, nose, and throat), or timing of reduction (realignment) if needed.

This X-ray may be ordered when a person has symptoms such as:

• Pain or tenderness over the bridge of the nose after an injury
• Swelling and bruising (including “black eyes”) following a facial impact
• A nose that looks crooked or newly deformed
• Nosebleeds (epistaxis) after being hit in the nose
• Difficulty breathing through one or both nostrils after injury (may suggest swelling, septal deviation, or other internal injury)
• A “crack” sound or feeling at the time of injury, or persistent localized pain

It may also be considered in situations such as sports injuries, falls, motor vehicle collisions, or assaults—especially when there is concern for a fracture or when documentation of injury is needed. If the clinician suspects more complex injuries (for example, fractures of the orbit/cheekbone, significant midface trauma, neurological symptoms, or severe facial swelling), diagnostic imaging with CT is often preferred because it can evaluate the entire facial skeleton more reliably.

Common diseases related to it

• Nasal bone fracture (acute fracture after trauma)
• Displaced nasal fracture (fracture with bone misalignment)
• Nasal bone deformity (post-traumatic or structural deformity of the nasal bridge)
• Facial fractures involving adjacent structures (suspected; may prompt further imaging)
• Septal deviation or septal injury (often evaluated clinically; may be associated with nasal trauma)
• Prior/healed nasal fracture (old injury noted on X-ray)

Health goals where it may help

• Confirming or ruling out a suspected nasal bone fracture after a blow to the nose
• Guiding treatment decisions after nasal trauma (e.g., observation vs. ENT referral or reduction)
• Assessing the extent of injury after facial trauma as part of an overall radiology workup
• Documenting injury and supporting safe return-to-activity decisions after sports-related facial injuries
• Evaluating persistent nasal pain or visible deformity following an injury