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 patients with 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.
Right hand x-rays
The carpal bones are malaligned or dislocated.
There is evidence of an acute fracture.
The fracture is at which part of the scaphoid?
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
- Scaphoid fracture is an important diagnostic consideration in a patient with wrist pain following a fall on an outstretched hand.
- Anatomic snuffbox tenderness is the most sensitive physical examination finding for a scaphoid fracture.
- A fracture of the proximal pole of the scaphoid places a patient at an elevated risk of avascular necrosis due to arterial supply to the scaphoid entering distally and feeding proximally.
- X-rays of the hand are the initial imaging modality of choice in a suspected scaphoid fracture.
Socioeconomic Factors: Hand trauma care is considered suboptimal in the United States because of the severe on-call hand-specialist shortage.
That's the end of the module! Once you've reviewed the video(s), you can click here for another case challenge.
Jordan Turetsky, MS4 - Content Contributor
Khalida Clark - Content Contributor
Kevin Pierre, MD - Editor
Robbie Slater, MD - Supervising Editor
Bayar Batmunh, MS - Coordinator