Q:

A 30 year old lady was playing volleyball when her hand got injured with the ball. The right hand is not swollen and there is tenderness under the root of the thumb. X-ray is normal. What is the most appropriate next management?

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A 30 year old lady was playing volleyball when her hand got injured with the ball. The right hand is not swollen and there is tenderness under the root of the thumb. X-ray is normal. What is the most appropriate next management?


  1. Arm sling for 1 wk
  2. Raise hand for 2d
  3. Repeat XR
  4. Full arm cast

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The key is C. Repeat X-ray. [Likely diagnosis is scaphoid fracture where X-ray may not show the fracture right away. In such case put her hand in a below elbow cast and repeat X-ray in a week or two to see if the fracture become visible. Usually it becomes visible as a healing fracture line].

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