Imaging Case of the Week 535 Answer

The hand x-ray shows:


evidence of impaction fracture in the distal radius. There is an avulsion fracture of hamate as well as significant soft tissue swelling around the wrist joint.

The role of plain x-ray in patients with dog/cat bite is to assess for underlying fracture, retained foreign body (tooth or claw), areas of soft tissue gas indicative of deep laceration.

Clinically it is important to assess for vascular, nerve, tendon injury.

The above patient was given a tetanus booster, intravenous augmentin and referred to specialist for urgent wound exploration and washout.

Further reading:

Imaging Spectrum of Bites, Stings, and Their Complications: Pictorial Review : American Journal of Roentgenology : Vol. 193, No. 3_supplement (AJR) (