Xray bone, CT if complex

tendon/ligament MRI or USS

Clinical Examination - Anatomy involved:

• Bone - phalanges, metacarpals, joints
• Tendons
• ligaments

Injuries

• Dislocations – always get an xray – associated fractures are common

• Certain types of trauma are associated with types of injury E.g. boxers fracture

• Some injuries are more likely to involve bones and tendons/ligament E.g. mallet finger

  

Hx of injury

• Fractures are prone to displacement due to opposing pull of tendon, therefore re-xray at 1 week,
• Consider other imaging if initial xray is normal but there is:
  • persistent pain
  • non healing after surgery
  • change of management in acute setting
    • Ultrasound; CT scan; bone scan; MRI
    • OR surgical referral. NB. collateral ligaments can involve growth plates in children
• If there is suspicion of Synovial involvement – consider MRI