Cracking the Case: How Doctors Diagnose Tricky Hamate Fractures
Published: Feb 24, 2024
Diagnosing a hamate fracture can be like solving a mystery. These small wrist bone injuries often slip under the radar, but with the right tools and techniques, doctors can crack the case.
Contents
The Initial Clues: Physical Examination
When a hamate fracture is suspected, doctors start with a careful physical exam. They'll look for tenderness over the hypothenar eminence (the padded area on the pinky side of your palm) and may perform special tests. One key test is the 'hook of hamate pull test,' where the doctor resists your finger flexion to check for pain.
X-Rays: The First Line of Investigation
Standard X-rays are usually the first imaging test, but they're not always reliable for hamate fractures. Only about 40% of hamate body fractures show up on regular views. For suspected hook fractures, special views like the 'carpal tunnel view' or a 20-degree supinated lateral view may be needed.
Advanced Imaging: When X-Rays Aren't Enough
If X-rays are inconclusive but suspicion remains high, doctors often turn to computed tomography (CT) scans. CT is highly sensitive for detecting hamate fractures, especially of the hook. Magnetic resonance imaging (MRI) is another option that can show both bone and soft tissue injuries.
Frequently Asked Questions
Standard X-rays miss up to 60% of hamate fractures; special views improve detection.
Not always, but it's often used when X-rays are negative and suspicion remains high.
Ultrasound isn't typically used for diagnosis but may help assess associated soft tissue injuries.
It can vary, sometimes taking weeks if initial tests are inconclusive.
Key Takeaways
While hamate fractures can be elusive, proper diagnosis is crucial for appropriate treatment and recovery.
Wondering if you might have a hamate fracture? Consult with Doctronic to learn about diagnostic options and next steps.Related Articles
References
Andresen R, et al. Invest Radiol 1999; 34:46.
Kato H, et al. Hand Surg 2000; 5:19.
Always discuss health information with your healthcare provider.