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Make the Diagnosis: His Lower Arm is a Mess, but Specifically, What Kind of Mess?

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Presentation

A 42-year-old man presented to the doctor with complaints of pain and swelling on his elbow and wrist and decreased range of motion after a fall onto his outstretched right arm. The patient recounted that he slipped and fell onto the icy pavement while shoveling his driveway earlier that day, after which he felt immediate swelling and pain on his right arm. On examination, there was elbow swelling and joint stiffness. A considerable amount of tenderness could be felt upon palpation of the forearm, elbow, and ulnar part of the wrist. Hemarthrosis was suspected on examination. Radiographic examination showed a distal radial ulnar joint (DRUJ) dislocation and visible deformity at the wrist joint. Can you diagnose this patient?


to use the Differential Builder in VisualDx to help you.

4% A. Distal radius fracture

5% B. Essex-Lopresti fracture

4% C. Lateral humeral condyle fracture

2% D. Monteggia fracture

Learnings

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