When Should You X-Ray a Child's Hyperextended Finger?

Most PIP hyperextension injuries do not require imaging studies unless there is joint deformity.

Radiographs are often obtained for the common childhood injury of hyperextended fingers. To develop management guidance, researchers prospectively studied consecutive children ages 6 to 16 years with proximal interphalangeal (PIP) joint hyperextension injuries of the long finger evaluated at a pediatric emergency department in Switzerland. The researchers determined associations between anterior-posterior and lateral radiographic findings and each of four clinical features: pain, mobility, stability, and deformity. Presence of at least one feature was considered high risk.

Of 300 children, 219 (233 injured fingers) were considered low risk and 81 (85 injured fingers) high risk. Radiography identified only 12 significant injuries — all in the…

Reviewing Author

F. Bruder Stapleton, MD

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Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

When Should You X-Ray a Child's Hyperextended Finger?

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Reviewing Author