examination of the wrist demonstrates radiolucent line extending partially across the waist of the carpal navicular bone consistent with undisplaced navicular bone fracture. i would suggest conservative management and progress evaluation in seven to ten days. in addition, there is a seperate bony ossicle projected adjacent to the ulner styloid process either representing old ununited fracture or possibly sesamoid bone. examination of the right thumb demonstrates small bony density projected along the palmar aspect of the interphalangeal joint most likely sesamoid bone. no associated defect in the adjacent bony cortex is noted; this would make avulsion fracture less likely.
impression: undisplaced right carpal navicular bone fracture.