Journal of Urgent Care Medicine

A 35-Year-Old Man with Pain After Punching a Wall

A 35-year-old male presents to urgent care complaining of pain over the metacarpal of the little finger after punching a wall in his home for reasons he chose not to explain. On exam, pain is evident with palpation at the base of the metacarpal. You note there is a deformity over the 5th metacarpal bone. The neurovascular status is intact. View the images taken and consider your next steps, along with possible diagnoses.

Clinical Challenge 2: March, 2007

The patient is a healthy 37-year-old who reports falling on his hand, with his thumb outstretched. Upon examination, you find local mild swelling and tenderness and decreased range of motion of the thumb. There is no snuffbox tenderness, however. View the x-rays taken (Figure 1) and consider what your next steps would be. Resolution of the case is described on the next page.