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  2. A swollen right hand
  3. A swollen right hand
Endgames Spot Diagnosis

A swollen right hand

BMJ 2025; 388 doi: https://doi.org/10.1136/bmj-2024-083088 (Published 06 February 2025) Cite this as: BMJ 2025;388:e083088
  1. Jiatian Li, resident doctor1,
  2. Bei Xu, consultant1,
  3. Tuo Yang, attending doctor12
  1. 1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
  2. 2Health Management Center, Xiangya Hospital, Central South University, Changsha, China
  1. Correspondence to: T Yang yangtuo{at}csu.edu.cn

A man in his 30s presented to the emergency department after becoming intoxicated and striking the ground with his right fist. He reported pain, swelling, and limited movement around his right fifth finger. Examination showed swelling and bruising of the right fifth distal metacarpal, accompanied by marked tenderness. There were no skin abrasions or neurovascular compromise. The range of motion in the other joints was normal. Radiographs were obtained during the initial evaluation (fig 1).

Fig 1

Anteroposterior and lateral radiographs of the right hand at time of presentation to the emergency department

Question

  1. What is the diagnosis?

Answer

The radiographs show a fracture of the right fifth metacarpal neck, with …

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