Maria, a 21-year-old university student presents with a tender and swollen right hand. The oblique X-ray findings are pictured.

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<p>Maria, a 21-year-old university student presents with a tender and swollen right hand.</p><p>The night before she had been out with friends and consumed about six drinks and an MDMA tablet. She does not recall sustaining any injury.</p><p>Maria is right-hand dominant. She has no past history of note and is generally very well.</p><p>Her wrist and hand are swollen; she is tender over the ulnar aspect of the hand and wrist and is unable to extend the wrist or make a fist.</p><p>Neurovascular examination is unremarkable. AP and lateral views of the wrist are normal.</p><p>The oblique X-ray findings are pictured.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.