Injuries initially misdiagnosed as sprained wrist (beware the sprained wrist)

To describe the injuries misdiagnosed as a sprain of the wrist and to determine the approximate incidence of misdiagnosis in patients diagnosed as having a sprain of the wrist.

All diagnostic errors in an accident and emergency (A&E) department were noted on a computerised database. Injuries initially misdiagnosed as wrist sprain are described and compared with the number of diagnoses of sprained wrist on the A&E department computer.

57 injuries initially diagnosed as a sprained wrist had a different diagnosis (1.76% of all diagnoses of sprained wrists). This is an underestimate of the true incidence of diagnostic error. Forty two per cent of the misdiagnoses were of greenstick or torus fractures of the distal radius.

Training for junior doctors in A&E departments should be improved-especially training in radiological interpretation. Other methods of preventing diagnostic errors by misreading of radiographs, for example, more hot reporting of radiographs by radiologists or radiographers should be considered.