Diagnosis of metacarpal fracture with equivocal x-ray by point-of-care ultrasound: a case report.

Metacarpal fractures represent a very common injury among patients presenting to the emergency department. Diagnosis is of utmost importance given the high morbidity associated with lack of full hand function. We report a case of a 37-year-old man who sustained extremity trauma after a mechanical fall. He presented with an examination that revealed diffuse tenderness over the wrist and hand. X-ray of the hand was equivocal for a metacarpal fracture; however, point-of-care ultrasound revealed disruption of the bony cortex confirming the diagnosis. The patient was splinted and referred for follow-up with a hand specialist. Point-of-care ultrasound may be useful for the diagnosis of hand fractures, which may reduce health care costs and radiation exposure in the future.