Reserved for extreme orthopedic emergencies in which an Orthopedic Surgery Attending directly requests an MSK Radiology Attending to clarify uncertain findings that will result in an acute change in patient management.  Upon this request, the resident should obtain the Orthopedic Attending contact information before reaching out to the MSK Attending.  Only an Orthopedic Attending can request for an MSK Attending interpretation after hours. 
Osteomyelitis and R/o Fracture cases are not emergencies that require an MSK attending  review after hours.  These studies are ordered to look for fluid collections and bone infection.  Together with acute fracture studies, they can be addressed by the weekend or night attending. A simple description of the fluid collection, bone erosion, or fracture is enough for the report.
All urgent night extremity CT’s should be finalized by the night attending.  Dr. Sicular is in agreement.
All after hours inpatient and  emergency MRIs’ should be reviewed and dictated by the resident on night float or weekend call.  If questions arise, they should be directed to the senior resident back-up, weekend or night attending as needed.
A resident preliminary dictation needs to answer the main emergent questions as well as communication of critical results: e.g. positive for soft tissue abscess, positive for osteomyelitis, positive for acute fracture.  If the night attending is consulted, the feedback should be included in the preliminary report.  A finalized MSK report will be provided on the next business day.
Additionally, on weekends and some late shifts, there will often be MSK trained attendings available, such as Dr. Obedian, Dr. Mclaughlin, and Dr. Pfaff (who is comfortable with most MSK MRI exams).  They should be consulted if on schedule at any site.