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Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: Health
Satisfied Customers: 5987
Experience:  Ob/Gyn
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Should I get another x ray?

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I suffered blunt force trauma to the lateral side of my forearm one week ago, near my wrist. I recently returned to work from medical leave, so after the incident I held my arm for a minute then told myself to ignore the pain. There was bruising immediately; never red or purple, just green. But later that day I was really in a lot of pain, despite favoring that arm, and I could feel (painfully) an uncomfortably large dent in my arm. Close to 48 hours later, after being unable to sleep even with a sleeping pill I decided to get an x ray, just in case. The doctor said my arm wasn't fractured and to ice it whenever I had a chance. Well I've been icing it, but now more bruising is showing up (this time it is purple) and it doesn't seem to be getting any better. I've had a bone bruise before on my shin, but this injury to my arm isn't anything like the shin injury. I'm wondering if I should get another x ray? And is it normal for there to be initial bruising followed by worse bruising a week later with a bone bruise?


Dr. Pfeiffer :

hello

Dr. Pfeiffer :

can I confirm the trauma was on the thumb side of the wrist?

Customer:

No, sorry I thought that would be the medial side. It was on the pinky side, about 1 1/2 inch above my wrist.

Customer:

Ulna side

Dr. Pfeiffer :

ok..thanks

Dr. Pfeiffer :

are you on medication or blood thinners

Customer:

I take birth control. That's it.

Dr. Pfeiffer :

ok

Dr. Pfeiffer :

so the good news is bones on that side of the hand have good blood flow...where this is a bone on the other side that does not.

Dr. Pfeiffer :

sounds like there is still quite a bit of inflammation.

Customer:

It doesn't appear to be swollen much, but it's definitely warm

Dr. Pfeiffer :

and this is probably a very bad bone bruse, which also caused soft tissue damage and inflammation...which is what causes the blood showing up as a bruise.

Customer:

Ok

Dr. Pfeiffer :

So...in my opinion, I would splint the hand, wrist and forearm for about a week..


Alternating cold and warm compressess throughout the day.


At 1 week I would have you evaluated by a physical therapist for progress to see if you needed to be splinted longer.


If there is no improvement with splinting...I would repeat the X-ray

Customer:

I definitely don't have any training in reading x rays, but when I looked at the x rays there was definitely something going on in that area. It looked to me like a periosteal reaction (onion). This seems odd because I thought a periosteal reaction doesn't usually show up until about a week after a fracture occurred and that a bone bruise isn't visible on an x ray. Plus I have been wearing the ace bandage for about a week with no improvement....

Dr. Pfeiffer :

yes..that's called a calous and generally signifies a healing fracture...or a healed old fracture.

Dr. Pfeiffer :

they make a thumb spika splint and that's what I would recommend for a week as I mentioned above.

Customer:

Alright. I will definitely try the thumb splint. But, just for clarification, is it normal for the callous to appear within 48 hours?

Dr. Pfeiffer :

that's a bit soon...and was probably assessed as a previous injury.

Dr. Pfeiffer :

Ok...if there's nothing else I can do for you please take the time to rate my service.


 

Dr. Pfeiffer :

thank you


Dr. Pfeiffer

Customer:

Sorry, but the reason why I'm concerned is because after the doctor told me my arm was fine, I asked him to explain why I now had a popping sensation when I rotated my arm and he proceeded to show me his double-jointed thumb. - on another note, that incident mentioned is the only time I have injured my forearm in I don't know how long.

Customer:

Well either way, I suppose it doesn't matter. I will try the thumb split, and see how it goes. Thank you for your help.

Dr. Pfeiffer :

ok...well, one of the wrist bones there has a round shape to it...so that's maybe what you saw on the X-ray.


The popping sensation is usually due to inflammation and swelling in the tendon sheaths that cause them to articulate or pop when sliding over bones. That usually goes away with time...and faster with appripriate immobilization, Ice/heat.

Customer:

No it wasn't at my wrist. It was the ulna.

Dr. Pfeiffer :

mid shaft, near the wrist or near the elbow?

Customer:

And far from the end of the ulna. Like I said the injury was about 1 1/2 inches away from my wrist.

Dr. Pfeiffer :

hard to say, but in that area I would think it was inflammation from soft tissue giving the appearance of a calous.

Customer:

Yes I know it is hard to give an opinion without seeing the x ray. I do appreciate your input, though. Thank you Dr. Pfeiffer.

Dr. Pfeiffer :

thank you

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