Does a break always show up on a x-ray?

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On Tuesday, ds (3) fell off of the arm of the sofa onto the floor and hurt his arm. He cried straight away and carried on crying on and off for an hour or so (very unlike him). So dh took him to A&E.

The injury was pin pointed to his wrist and he had an x-ray. Nothing showed up on the x-ray and they put it down to a probable sprain.

So, 3-4 days later and ds still won't use his arm. There hasnt been any swelling, but he keeps it dangled beside him and he cries out in pain if the wrist is moved in a certain way.

If it was a sprain, would there always be swelling?

If things haven't improved we will be off to A&E tomorrow, but I just wondered what other people's experiences were.

Hi I'm an adult A&E nurse, the xray will have been checked by a senior radiographer the next day and if it was positive you would have received a phone call.

Sprain's can be as bad as a fracture, as in pain and swelling,lots of calpol and ibuprofen and hopefully he will eventually start using it???

Have you tried to "trick" him by offering him a treat in the hope he will take it using the affected arm!!

Hope they assessed it properly and it's deffo his wrist rather than elbow!?!?

Good luck xx

We were told that breaks sometimes show up better once they start to heal. DS broke an ankle a few years back and it was only on re-xray that it showed up.

I can concur with nurseneedshelp perspective as both of my children have hurt their legs and been unable to walk, been x-rayed at A & E and pronounced fine, then we've received a phone call the next day from a senior radiographer saying that there was indeed a hairline fracture.

I'd take him back to A & E. It probably is fine, but worth getting checked. I broke and sprained one of my wrists as a child, and the sprain was definitely more painful and swelled more btw.

HTH.

Just a thought, there's a potential scaphoid fracture (in the wrist) and they don't show up for 3 weeks but it's very rare for a child to sustain this injury and the staff would have given a splint and a 3 week clinic appointment for a repeat xray if they suspected this??!! X

Sometimes fractures don't show up until you can see the healing (callus formation).

I know he had a fall rather than a pull but I do wonder if it could be a pulled elbow type of injury??

Many thanks for your experiences and thoughts, it's much appreciated.

A&E did mention a pull on the elbow, but I am totally sure that it is his wrist and not his elbow.

I have tried to sneakily catch him out and get him to use his arm, but he won't use it.

My DS wasn't recalled until the Wednesday after he broke his leg one weekend! At least they had strapped it and given him crutches.

But when he broke his scaphoid (small wrist bone) they said we were extremely lucky to be able to see it on day of the break as often they cast "to be safe" and re x-ray in a week when the break will be visible!

(He proceeded to break his ulna within a month of scaphoid cast being removed!)

Stress (hairline) fractures don't show up on X-rays right away! I broke my pelvis in two places a couple of years ago and had it x-rayed the same week...it showed nothing . A bone scan and MRI three months later ( after near-constant pain and immobility )showed the fractures plain-as-day. I had been told it was a groin pull. Bone pain throbs and aches like nothing else (particularly at night/rest). Follow your instincts .

Thing is, we often protect the injured body part subconsciously if it is fractured, so that body part begins to heal anyway, like not weight bearing on an injured foot or ankle.

It's very true that sometimes, undisplaced fractures just don't show up on initial xray. With young children who still have as much cartilage as bone, it can be a real problem (cartilage doesn't show on xrays).

If I were you and your DC can't be 'tricked' into using the injured part I'd take them back to A&E for a further review.

DS2 had a greenstick fracture of the wrist. I could barely see anything on the xray. It happened on the Saturday and I didn't take him to minor injuries til the Wednesday, I thought he was ok.

I would go back if I were you.

3 year olds won't have a scaphoid bone yet so that's not a worry. X-rays routinely take two views which are universal but sometimes you would need an oblique/slanted view to show something up. Go with your instinct and take him back.

Just got back from A&E.

He has a cast on from pit to wrist. And the problem is his elbow, not his wrist as originally thought.

He had an x- ray which only showed fluid build up. So they aren't really sure what is going on. His accident didn't involve pulling at the elbow, so they are erring on the side of caution and we are going to the fracture clinic on Tuesday.

Thanks for your thoughts, experiences and suggestions

Glad he's sorted, sometimes you have to go with how you feel. They will have spotted two little 'triangles' of fluid above his elbow joint probably, these indicate swelling in the joint which could be caused by fractures. Children's elbows are very hard to read because of all the areas of bone growth appearing at different times. DS1 had a knuckle to shoulder cast on one summer and was totally un-bothered by it after the first day.

I can't believe how totally unbothered he is by the cast. He has actually been in better spirits since it has been on, so I think it's more comfortable for him. I'm sure I wouldn't have adapted as well as he has

When they do a sideways Xray of an elbow, they look for what's called the posterior fat pad. If it's visible, it tends to mean there is probably a fracture there which can't be seen on the bone, That's a very common occurrence (not being able to see the fracture)! In a DC it's usually a fracture in the humerus (upper bone of the arm) at the elbow; in an adult it indicates a fracture of the head of the radius bone, lower arm, in the elbow, .

FWIW, DS2 (aged 2) got a greenstick in his fibula 2 weeks and 3 days prior to us emigrating from Oz to here. I nearly had a nervous breakdown as I looked at the xray and saw it! However, DH brought him home in a toes to hip cast, and within 20 mins DS2 was running around the house on it. I begged the doc to take the cast off for the 27 hour journey to the UK which they did. Not a problem since, of course.

My 15yr old child proceed to hurt his wrist. I took him immediately to A&E where they described my sons wrist as "a normal wrist". He carried on complaning about his wrist so I took him back the following week, there they described my sons wrist with a hairline fracture

My only advise to you moms out there is too follow your childs instinct it is very powerful at times.