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Dr. Andrew Rynne

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Severe pain on elbow after injury. X-ray clear. Swelling and bruised appeared. What to do?

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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 15545 Questions

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Posted on Sat, 16 Feb 2013 in Bones, Muscles and Joints
Question: Hi Doctor I fell on my elbow last night on ice and went to the ER tonight, they said they couldn't see a fracture on the x XXXXXXX is it possible the x XXXXXXX could've missed it? My elbow is very painful when pressing a specific spot a little bit above the main tip. It's also swollen and very bruised.. Should I go back to see a dr or possibly an orthopedic or just wait?
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Answered by Dr. Michelle Gibson James 34 minutes later
Hi, thanks for using healthcare magic

In most cases the initial examination and xray should reveal a fracture, however a medical study published in 2006 in BMC emergency medicine revealed that just over 3% of fractures were initially missed in the ER.

It is possible that it is only a soft tissue injury- these can cause significant pain, swelling and bruising but if the pain and swelling does not start receding after 24 to 48 hrs, then you need to consider re visiting your doctor for a repeat assessment.

In the meantime you can practice what is called R.I.C.E. This stands for rest, icing the area of injury, compression-use a bandage to reduce the swelling and elevation- elevation of the affected are reduces the swelling and may also have a positve impact on the pain.
Also continue using the pain killers that they would have given you.

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Michelle Gibson James 15 hours later
The thing is, I normally have very high pain threshold (when i was a kid I had a broken arm for a week before my parents took me to see a dr) so this doesn't seem right to me.. It's just as swollen and painful as on the night it happened and it's not getting any better I have strong suspicion there's something more to it than soft tissue damage.. I know it's not likely to hurt your ligaments by falling directly on your elbow but could that still be the culprit? Or something else I should be aware of that's not related to bone fractures? It's so painful right now that it feels like it's stuck in one position.
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Answered by Dr. Michelle Gibson James 2 hours later
Hi

If at least 36 hrs later it is still significantly swollen and painful, with not even the slightest improvement , then I do believe you should have yourself reassessed.
As mentioned, it has been documented that some fractures can be missed and it is better safe than sorry.

feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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