OpenHealth Q&A

Should I Seek Further Imaging After My Injury?

**Context:** I am a 34-year-old person (AFAB) without any chronic ailments or significant past injuries. Recently, I experienced a fall down some stairs, where I landed awkwardly, absorbing the impact with my elbows. Imagine slipping on a staircase coated in ice, sending your feet forward while your back meets the ground. The pain was immediate and, quite frankly, the most intense I’ve ever encountered. I felt dazed and had to call my spouse to come home from work to assist me. My left arm swelled significantly from the elbow down, and I found it impossible to bend it past a right angle; the most comfortable position was to keep it extended straight out. Despite several attempts to visit urgent care facilities, we were faced with closures or high patient volumes, a typical issue in a semi-rural area. Eventually, we went to the emergency room. They performed X-rays on my left forearm, capturing images while it was bent at 90 degrees and in various positions. The diagnosis was a major soft tissue injury, indicating no fractures were present. I was advised to apply the RICE method (Rest, Ice, Compression, Elevation), use a sling for 48 hours, manage the pain with ibuprofen and Tylenol, and return if symptoms persisted beyond a week. I must admit, the incident stirred up quite an emotional response. The pain was unlike anything I had previously experienced, and reflecting on my childhood experience when my broken leg went untreated for days by my parents heightened my sensitivity to pain being overlooked. My mother-in-law, a Nurse Practitioner, was in constant communication, helping clarify medical details, and even she found it concerning that it was the emergency doctor who assessed my X-rays instead of a radiologist. Regardless, the X-ray results indicated no fractures, which was ultimately a relief, leading us to leave the hospital. **Now fast forward:** I upheld RICE for 72 hours, leading to reduced swelling. The bruising remains, though it has transitioned to a softer yellow hue, surfacing as the injury’s depth lessens. After a week and a half, I regained nearly full function of my arm with minimal swelling. However, there’s a troubling aspect. Whenever I apply pressure to either elbow, such as when I try to prop myself up in bed, I experience a quick, sharp pain followed by throbbing discomfort. Although the left arm, the one that suffered the injury, is notably worse, there’s also a milder pain in my right elbow. My mother-in-law is concerned that there might be a hairline fracture at the elbow's base that could have been overlooked. She suggests that I return for further imaging or at least get a consultation with my primary care provider, who is a Family Nurse Practitioner. However, I’m currently not in a position to bear the financial burden of a second ER visit and question if it’s truly necessary, especially since I can continue to rest my arm and avoid leaning on it for a while longer. **In summary:** Could the ER have possibly missed hairline fractures, and should I seek another evaluation?

Answers (1)

7/21/2025, 1:02:05 PM

OpenHealth AI

Based on your detailed description, it sounds like you’ve experienced a significant injury to your left arm with some ongoing symptoms that are understandably concerning. While the X-rays taken at the emergency room did not show any fractures, the presence of pain when applying pressure or using the elbows suggests a few possibilities, including soft tissue damage, joint inflammation, or even a hairline fracture that may not have been visible at the time.

Explanation

X-rays are effective for identifying fractures, but subtle or hairline fractures can sometimes be missed, especially if they are not in areas where the imaging is typically focused. Pain after a significant injury is common and can occur due to muscle or ligament damage, or inflammation in the surrounding tissues. It’s great to hear you're experiencing improvement and regaining function, but ongoing sharp pain warrants further consideration.

Next Steps

1. Monitor Your Symptoms: Keep track of any changes in pain intensity, mobility, or function. If symptoms worsen or if you notice any new symptoms, it may emphasize the need for further evaluation.

2. Rest and Modify Activity: Continue to avoid activities that put pressure on your elbows. Use support, like a pillow, when resting to avoid straining the area.

3. Pain Management: Continue using over-the-counter pain relief as needed, following the recommended dosages. Ice can also help manage any inflammation.

4. Evaluate the Need for Imaging:

   • If pain persists significantly when pressure is applied, or if it interferes with your daily activities despite conservative measures, it may be prudent to seek further imaging.
   • You might consider visiting your primary care provider rather than the ER, as this can be a more cost-effective option for getting a second opinion or further assessment.

5. Decide on Consultation: Discuss your concerns with your mother-in-law and explore the option of a telehealth visit with your primary care provider if in-person appointments are difficult. This might be less financially burdensome and still provide you with professional advice on the need for further evaluation.

Reassurance

It’s understandable to feel anxious about potential missed injuries, especially given your past experiences. Remember that your ongoing recovery is positive, and continuing to care for your arm with proper rest and pain management will support healing. Keeping an open line of communication with family and healthcare providers can help you navigate your recovery and ensure you get the care you need if symptoms don’t resolve.

Feel free to reach out if you have further questions or need more guidance!