Quick quiz for EM/ENP board review: a 40‑year‑old woman with radial‑sided wrist pain and limited ROM — identify the likely scaphoid injury and review key radiograph clues and exam pearls.
A 40-year-old woman presents to your office complaining of pain and decreased range of motion in her right wrist. She does not remember when the pain started, but she has noticed that it has become more prevalent and has quickly increased in intensity over the last few months. She says that her right wrist has been "bothering" her, stating that she first noticed it while typing on the computer, but lately it has been "constantly burdensome." She denies any falls, trauma, or strenuous physical activity. She denies fever, shortness of breath, or chest pain.
Vital signs are within normal limits. Physical examination findings include point tenderness at the distal end of the right radius, and decreased flexion and extension of the right wrist when compared with the left. There is a large, solid, and fixed mass at the distal end of the radius extending laterally and into the carpal region.
X-ray of the right wrist showed the following (see Figure).
Figure.
What is the most likely diagnosis?
This question appears in Med-Challenger Physician Assistant Exam Review with CME
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