A 19 year-old white female softball player presented to our clinic with right hand pain. She had been participating in “wind sprints” when she tripped and fell to the ground hitting her right hand against a decorative boulder. The athlete noted discomfort over the volar aspect of the 4th and 5th metacarpal bones. She presented to our clinic for further evaluation. The athlete has no significant past medical history and is not on regular medications.
PHYSICAL EXAM:
Right hand – swelling and ecchymosis is appreciated over the 4th and 5th metarcarpals. Flexion and extension is intact at the DIP, PIP, and MCP joints. No shortening or rotational defect is appreciated. Pain is more pronounced with palpation at the head of the 4th metacarpal however the athlete notes discomfort along the 5th metacarpal. Superficial abrasions are noted over this area. Neurovascular exam is unremarkable.
Initial Differential Diagnosis Based on the History and Physical:
