A 23-Year-Old Man Comes to the Office Due to Right

question 446

Multiple Choice

A 23-year-old man comes to the office due to right wrist pain.  Earlier today, while running to home plate during a baseball game, he landed forcefully on his outstretched right hand with the palm facing down.  Since then, the patient has had right wrist pain and swelling.  He has had partial relief with acetaminophen and local application of ice packs, but the pain still limits his activities.  The patient's medical history is unremarkable.  Vital signs are normal.  Physical examination shows mild swelling at the dorsum of the right wrist.  There is maximal tenderness proximal to the base of the first metacarpal, and the pain worsens with radial deviation of the wrist.  Radiographs of the wrist in multiple views reveal no fracture or dislocation.  Which of the following is the most appropriate next step in management of this patient?

• A)Analgesics and physical therapy
• B)Local anesthetic and corticosteroid injection
• C)Surgical exploration and tendon repair
• D)Synovial fluid aspiration and analysis
• E)Thumb spica splint and repeat radiography in 10 days

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Definitions:

Unintentional Use

The misuse of substances or products without the purpose or awareness of causing harm or illegal activity.

Prescription Drugs

Medicines that can only be obtained with a written order from a healthcare professional, used for diagnosing, treating, or preventing diseases.

Intoxicating Effects

The physiological and psychological effects caused by consuming substances that impair cognitive and physical functions.

Smokers Gain

Weight gain that is sometimes experienced after quitting smoking, attributed to an increased appetite and decreased metabolic rate.