Radiology Review

Wrist Pain After a Fall

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A 90-year-old man is brought to your facility for evaluation after a fall. The patient states he was out in his yard, near his garden, when he “just passed out.” He landed in an ant bed and was eventually found by a neighbor, who brought him for evaluation. The patient says he has felt weak for the past several days. He has no other constitutional complaints. He is also experiencing bilateral wrist pain, he presumes as a result of receiving multiple ant bites. His medical history is significant for diabetes. His vital signs are normal. Inspection of both wrists demonstrates mild to moderate circumferential swelling with several raised, reddened bumps. Both wrists are tender; range of motion does cause some tenderness. Sensation is intact, and good capillary refill time is noted. While waiting for lab results, you obtain a radiograph of the left wrist (shown). What is your impression?


 

ANSWER
The radiograph shows some osteopenia and significant vascular calcifications. Of note, there is a fracture of the styloid process of the radius, extending slightly to the joint space. The patient was placed in a splint and orthopedic referral was obtained.

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