Concerns About a Potential Scaphoid Fracture
Age: 38. Daily supplements include vitamins and ibuprofen at a dosage of 800mg. I occasionally use cannabis, am a nondrinker, and do not smoke. I maintain an active lifestyle. Approximately 12 weeks ago, while skiing, I suffered a significant fall where I landed hard on my outstretched hand, inadvertently jamming my ski pole into the space between my thumb and index finger. Although I felt intense pain during the incident, I retained most of my grip strength. A few days later, as the pain intensified, I decided to get X-rays. Urgent Care diagnosed it as either a sprain or a bone bruise, provided me with a brace, and advised me to rest. Two weeks afterward, I consulted with a specialist focused on hand and wrist injuries. The initial X-ray led him to suspect a fracture in my trapezium bone. He put me in a cast and arranged for a CT scan. When the CT results arrived three weeks later, they indicated no fracture or conclusive evidence of injury, aside from a widening at the scapholunate junction. The doctor then removed my cast, and I opted for a custom-fitted brace while scheduling an MRI. The MRI findings came back largely negative, showing only vague damage to the triangular fibrocartilage complex (TFCC) and the presence of a ganglion cyst. Now, 12 weeks following the injury, I continue to endure considerable pain when I press on the anatomical snuffbox, with discomfort radiating through my hand and forearm. I have ceased using the brace as I wish to strengthen my hand, but I am left with pain that persists throughout the day. During my MRI assessment, I noticed a particular area (indicated with an arrow in the provided images) that seems displaced. Since three different doctors have evaluated this MRI, I assume they recognized this anomaly, but I neglected to ask about it and would like clarity. I intend to follow up with my doctor but want to be well-informed for our next discussion. The ongoing medical expenses are concerning, and I feel I lack a clear diagnosis or treatment plan. Thank you for any insights you might offer.
Answers (1)
3/22/2025, 6:00:43 AM
OpenHealth AI
It sounds like you've been through quite a process with your wrist injury, and I understand your frustration with the lack of a clear diagnosis and ongoing pain. Based on your description, the persistent pain, especially in the anatomical snuffbox region, raises the possibility of undiagnosed issues that can also be attributed to a scaphoid fracture or other injuries around the wrist that may not have been detected during imaging.
Explanation:
The anatomical snuffbox is an important area of the wrist where pain can indicate potential issues with bones like the scaphoid, even if initial scans show no fractures. Scaphoid fractures can be tricky because they sometimes don’t show up on X-rays immediately but can lead to chronic pain if not treated properly. The widening at the scapholunate junction and the damage to the triangular fibrocartilage complex (TFCC) indicate that there might still be underlying soft tissue injuries, which could also be contributing to your symptoms.
Next Steps:
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Document Your Symptoms: Keep a log of your pain levels, what activities aggravate it, and any other symptoms. This can help in discussing your condition with your doctor.
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Seek Clarity on Imaging: During your follow-up, ask specifically about the area you marked on your MRI. Inquire if it's related to your pain and what the potential implications of that finding might be.
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Consider a Referral: If your current doctor isn’t providing the answers you need, consider asking for a second opinion, potentially from another specialist in hand injuries who can review your imaging with a fresh perspective.
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Follow a Rehabilitation Program: While you want to avoid using a brace, a guided rehabilitation program focusing on range-of-motion and strengthening exercises might be beneficial. A physical therapist can tailor this plan to help manage pain and improve function.
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Explore Pain Management Options: Discuss with your healthcare provider about other pain management strategies that might include modifications in your current ibuprofen use, physical therapy interventions, or potential considerations for therapeutic injections.
Final Note:
It's important to advocate for yourself and seek answers that address your persistent pain and concerns. Suffering ongoing discomfort after an injury can be very challenging, but with the right approach and communication with your healthcare team, you can work toward finding a resolution and an effective treatment plan. You're not alone in this, and it's commendable that you're being proactive about your health.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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