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Painful swelling of the hand
  1. Jiri Moekotte,
  2. Thomas C Schuurs
  1. Department of Emergency Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands
  1. Correspondence to Jiri Moekotte, Emergency Medicine, Amsterdam UMC Locatie VUmc, Amsterdam 1081 HV, The Netherlands; jirimoekotte{at}

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Clinical introduction

A 26-year-old patient with no prior medical history presented to the emergency department with pain in his right hand after getting into a fight with another person. Figure 1 shows the hand. The function was impaired by pain. Vascularisation of the hand and fingers was normal and there was no neurological deficit. An X-ray of the hand was taken (figure 2).

Figure 1

Patient’s right hand.

Figure 2

Posteroanterior X-ray of the right hand.


What is the diagnosis?

  1. Triquetral …

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  • Contributors JM wrote the manuscript for the image challenge and gathered the clinical and radiographic images. TS reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.