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This is x ray of left hand of 54 year old male who have met minor accident

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wrist fractures radiography

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ACR Appropriateness Criteria acute hand and wrist trauma radiographs occult fracture

Probable finding: there appears to be an intra-articular fracture at the base of the left first metacarpal (thumb metacarpal), with possible mild displacement/subluxation at the thumb carpometacarpal joint. This pattern can represent a Bennett-type fracture.
I do not see an obvious distal-radius fracture or major wrist dislocation on this photographed film, but this is not a substitute for a formal radiology report. The photographed image and lack of dedicated thumb views limit certainty. There may also be chronic degenerative change around the thumb base/wrist.
What to do
  • Arrange urgent review by an orthopedic or hand surgeon, ideally today or within 24 hours. Intra-articular thumb-base fractures can need reduction and fixation if displaced.
  • Until assessed: keep the thumb/wrist immobilized in a thumb-spica splint, elevate the hand, apply ice wrapped in cloth for 15-20 minutes at a time, and avoid gripping or using the thumb.
  • Go to emergency care immediately for numbness, blue/pale/cold thumb, rapidly worsening swelling or pain, open wound, or deformity.
When initial radiographs are equivocal or incomplete after wrist/hand trauma, further dedicated views or CT/MRI may be appropriate to identify occult carpal or intra-articular injuries, as noted in the ACR hand and wrist trauma guidance.

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Bennett fracture radiography

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Bennett fracture base first metacarpal radiographs diagnosis thumb carpometacarpal joint

On a second review, the most concerning visible abnormality is at the base of the first metacarpal, the thumb bone, near the thumb carpometacarpal (CMC) joint.
Likely impression
  • Fracture at the base of the left first metacarpal
  • The fracture appears to extend into or very near the thumb CMC joint, with possible slight joint malalignment.
  • This is suspicious for a Bennett fracture pattern or another intra-articular base-of-thumb fracture.
  • I do not see a clear acute fracture of the distal radius or ulna on these views.
  • The wrist/hand also appears to have some chronic degenerative change, especially around the thumb base, but that does not exclude a new fracture.
Because this is a photo of an X-ray film and not the original digital images with dedicated thumb views, I cannot confirm the exact fracture type or displacement. A dedicated thumb X-ray series, and sometimes CT, helps determine whether the joint is displaced.
Recommendation: Treat this as a potentially unstable thumb-base fracture until reviewed. Immobilize the thumb and wrist in a thumb-spica splint, avoid gripping or thumb movement, and see an orthopedic/hand surgeon urgently. If the thumb becomes numb, pale/blue, cold, severely swollen, or pain rapidly worsens, seek emergency care.
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Same person having right leg involvement

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Lisfranc injury radiography

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ACR acute foot trauma radiographs negative Lisfranc injury CT MRI

This image is of the right foot, not the full leg. On these photographed AP, oblique, and lateral foot views:
  • I do not see an obvious displaced acute fracture or dislocation.
  • The overall tarsometatarsal alignment appears maintained, without a clear Lisfranc fracture-dislocation.
  • There are likely mild chronic degenerative changes, particularly around the great-toe joint and midfoot.
  • A subtle nondisplaced fracture, small avulsion injury, or ligament injury can still be missed on photographed, non-weight-bearing X-rays.
If he has marked pain/swelling in the midfoot, cannot bear weight, or has bruising on the sole of the foot, he needs prompt orthopedic assessment. A weight-bearing foot X-ray and, if suspicion remains, CT or MRI may be needed to exclude an occult fracture or Lisfranc ligament injury. The ACR foot-trauma evidence review notes that subtle Lisfranc injuries may not be clear on routine radiographs.
Until reviewed: limit weight-bearing, elevate, ice wrapped in cloth, use a firm-soled shoe or splint if provided, and seek urgent care for increasing pain/swelling, numbness, a cold/pale foot, open wound, or inability to take four steps.
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