Medical Council of Canada MCCQE Part 1 MCCQE Question # 53 Topic 6 Discussion

Scaphoid fractures are often radiographically occult on initial presentation and can present later with persistent pain and swelling in the anatomical snuffbox. They typically occur following a fall on an outstretched hand. If missed, they can lead to avascular necrosis.

Toronto Notes 2023 – Orthopedics, Wrist Injuries:

“Scaphoid fractures are the most common carpal fractures. X-rays may be negative early, so high suspicion requires immobilization and repeat imaging after 10–14 days.”

MCCQE1 Objectives – Surgery > Musculoskeletal Trauma:

“Candidates must recognize that some fractures, such as scaphoid, may not appear on initial imaging but require clinical suspicion and follow-up imaging or immobilization.”

Other options (B and C) are less likely without radiographic evidence. De Quervain tenosynovitis (D) presents with radial wrist pain unrelated to trauma and worsens with thumb movement.

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