According to Dr. Greg Gilbert, from Stanford University Medical Center, x-rays of the nose serve no purpose in diagnosing nasal fractures:
“A nasal fracture is a clinical diagnosis and not one that should be made with radiographs. They have a high false positive rate and cannot be relied upon with any degree of certainty as whether a nasal fracture is present or not.”
What is a “clinical diagnosis”? It is the use of a physical exam and a health history to determine a diagnosis. In the case of nasal fractures, it involves assessing for deformity, bruising, swelling, and tenderness. Questions about the injury are asked – How did this happen? Where did the object impact and from what direction? Have you ever had a nasal fracture? Do you have any other conditions? These signs and symptoms are then used to determine whether or not a nasal fracture is likely to exist. A referral may be made to a specialist, especially if surgery is possible.
Another item that may be useful in confirming a diagnosis is the recovery. Nasal fractures can take 6-8 weeks to heal and one would expect tenderness for many days, possibly weeks, while this healing process occurs. If the tenderness is gone within a day or two, it is unlikely that a nasal fracture is present.
For our newsletter and blog this month we are discussing nasal fractures. The blog topics for this month are:
- What is a nasal fracture, really? (5/1/15)
- Does the patient in your case have a nasal fracture? (5/8/15)
- Nasal Fractures: What does the literature say? (5/15/15)
- Legal Implications (5/22/15)
Note: To see all posts in this topic, click here