Man with hand pain

Emerg Med J. 2018 Dec;35(12):731-754. doi: 10.1136/emermed-2018-207679. Epub 2018 Apr 28.

Abstract

CLINICAL INTRODUCTION: A right-hand dominant man was transferred to our institution for evaluation by the hand surgery service. He reported that the day prior he had been sliding a sheet of plywood across the ground when he lost his grip, causing the board to slide across his left hand. He presented to an outside hospital where local exploration of the wound did not reveal any foreign body. On arrival, he complained only of mild pain in his hand. Physical examination revealed erythema and swelling over the thenar eminence and a small open area without any drainage. Radiographs (figure 1) and ultrasonography (figures 2 and 3, online supplementary video 1 and 2) were performed.DC1SP110.1136/emermed-2018-207679.supp1Supplementary dataemermed;35/12/731/F1F1F1Figure 1Radiograph of the hand.emermed;35/12/731/F2F2F2Figure 2Long-axis ultrasonography of the hand.emermed;35/12/731/F3F3F3Figure 3Short-axis ultrasonography of the hand. QUESTION: What is you diagnosis?Fracture of the metacarpal of the thumb.Cellulitis of the thenar eminence.Abscess of the thenar eminence.Retained foreign body.

Keywords: X-ray; hand injury; ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Emergency Service, Hospital / organization & administration
  • Fractures, Bone / diagnosis*
  • Fractures, Bone / diagnostic imaging
  • Hand / diagnostic imaging
  • Humans
  • Male
  • Metacarpal Bones / diagnostic imaging
  • Metacarpal Bones / injuries*
  • Pain / etiology
  • Radiography / methods
  • Ultrasonography / methods