Radiology Review

From Local Bar to Police Car

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From Local Bar to Police Car image

A 31-year-old man is brought to your facility by local law enforcement for evaluation of left wrist pain following an altercation. The patient was reportedly at a local bar; as he was leaving, he started arguing with some other patrons. A fight ensued.

The patient believes he was struck by something on his left wrist. He denies any other injuries or complaints. His medical history is unremarkable, and vital signs are stable.

Physical examination of his left wrist shows no obvious deformity. There is some mild swelling over the dorsal aspect of his wrist. Range of motion is painful and limited. Good capillary refill is noted in the fingers, and sensation is intact. Good pulses are present.

Radiograph of the left wrist is obtained. What is your impression?


 

From Local Bar to Police Car image

ANSWER

The radiograph demonstrates no acute injury to the wrist. There is, however, a subtle nondisplaced fracture of the distal fifth metacarpal joint. The patient was given a wrist splint for symptomatic relief, and orthopedic follow-up was coordinated.

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