Review the Learning Outcomes, Hx, PE and Labs, and begin the module with your Provisional Diagnosis. Keep hitting "Next" to move through the module.
- Articulate your relationship with the consulting diagnostic radiologists in the evaluation of a patient with hand pain.
- Review the DDx considerations in hand pain.
- Identify the spectrum of imaging findings in appropriate modalities for evaluating patients with hand pain.
What is your assessment of the likely acuity for this patient?
First Imaging Study
What is the first imaging study you will order?
Pertinent Imaging Observations
Click on the links below to view images from the study, and assess these key findings as best you can.
What best describes the findings on the hand radiographs?
Watch our video
Second Imaging Study
What is the next imaging study you will order?
What is your Diagnosis now that you have seen the imaging results?
Initially, you selected and we suggested acuity.
Has your concern for this patient changed?
Assessment and Plan
Please provide your assessment and plan for this patient
- A boxer’s fracture is a 5th metacarpal neck fracture that is more commonly seen in men and accounts for approximately 10% of all hand fractures.
- It presents clinically with pain on the dorsum of the 5th metacarpal along with ecchymosis, swelling, and potential angulation of the fracture apex.
- Radiography is the initial imaging test sufficient to establish the diagnosis and determine degree of displacement.
- Splinting is the standard of care for patients with this diagnosis. Surgical intervention is typically indicated during cases of open metacarpal neck fractures, fractures resulting in neurovascular abnormalities, comminuted fractures, or angulated fractures.
- Boxer’s fractures most commonly occur in Caucasian males aged 19 to 38 with a lower socioeconomic status.
- Most cases of boxer’s fracture are caused by alcohol, which also contributes to putting off prompt treatment.
That's the end of the module! Once you've reviewed the video(s), you can click here for another case challenge.
Jay Talati, MS2 - Content Contributor
Eva Merlob - Content Contributor
Kevin Pierre, MD - Editor
Robbie Slater, MD - Supervising Editor
Bayar Batmunh, MS - Coordinator