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The patient is a 10-year-old boy who received a blow to the forearm when he fell at home. He presented with local swelling and tenderness on exam, complaining of severe pain in his wrist.

View the x-rays taken (Figure 1 and Figure 2) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Clinical Challenge 2: December 2007

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services