Adam is a 32-year-old right-handed office worker who presents with pain and restricted movement of his right hand.

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<p>Adam is a 32-year-old right-handed office worker who presents with pain and restricted movement of his right hand.</p><p>Adam sheepishly confesses he drank too much the night before, and during an overenthusiastic playfight with mates on the walk home, he accidentally struck a telegraph pole with a clenched right fist.</p><p>He reported pain, swelling and limited movement around the medial aspect of the hand and pinkie finger.</p><p>Examination reveals the affected area is swollen and bruised, accompanied by marked tenderness and restricted range in attempting to make a fist.</p><p>There are no skin abrasions and neurovascular compromise.</p><p>The range of motion in the other joints is normal. He is sent for X-rays (pictured.)</p>

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