Presentation
Painful wrist post fall
Patient Data
There is a disruption in the cortex of the dorsal aspect of the distal radius seen in the lateral projection, suggestive of a nondisplaced fracture.
Acute undisplaced distal radius fracture, periosteal lifting in the ulna aspect with no intraarticular component. Cysts in the capitate most likely intraosseous ganglion.
Case Discussion
This case was flagged as abnormal by the attending radiographer, yet the patient was discharged with a 'sprained' wrist.
Although this particular example did not adversely affect the patient's overall care, it does highlight two things, the importance of assessing all aspect of the radiograph, and the value of radiographer alert systems 1,3.
Targeted radiographic image interpretation training undertaken by junior clinicians can decrease the possibility of missing injuries such as this in the emergency department 2.
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