Give a Hand
When a fall or crushing blow causes hand trauma, the injury can result in a fracture. Decipher these emergency radiographs to determine what needs attention.
Match the diagnosis to the photo by letter
a. Proximal fifth phalanx
b. Distal fourth metacarpal head
c. Scaphoid bone
d. Styloid process of the radius
For answers, see next issue; for discussion, go to www.mdedge.com/clinicianreviews/articles/picture
2. A 90-year-old man “just passed out” in his yard, landing in an ant nest. He experiences bilateral wrist pain, presumably from multiple ant bites. Both wrists are tender; range of motion causes tenderness. Inspection demonstrates mild to moderate circumferential swelling with several raised, reddened bumps.
Diagnosis: 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.
,Wrist Pain After a Fall. Clinician Reviews. 2012;22(9):22.
