Bones out of place? Wrist fractures

Case presentation

An 11-year-old male presents with left wrist pain and swelling 3 days after he fell while playing soccer. Apparently, in the course of the game, he fell on his outstretched left arm. After the injury, he continued to play but later in the day he noted pain and swelling to the left wrist. He denies neck, shoulder, elbow, upper arm, hand, or digit pain. He denies back pain.

Physical examination reveals a well-appearing patient, in no distress, with age-appropriate vital signs. He has obvious swelling to the left wrist and there is pain with palpation of the distal radius and ulna; this pain is reproduced with movement of the wrist. He has no shoulder, upper arm, elbow, or hand tenderness or swelling and there is full range of motion at these areas. His radial pulse is strong with good capillary refill. He is grossly neurovascularly intact.

Imaging considerations