n 82-year-old woman presents to the emergency department (ED) for new onset wrist pain. She notes that she was walking

n 82-year-old woman presents to the emergency department (ED) for new onset wrist pain. She notes that she was walking her small dog on a leash the evening before and heard a “popping sound” in her wrist when the dog tried to run away. She notes severe pain and swelling to the right wrist. She has a history of cerebrovascular accident, breast cancer (left mastectomy at age 57), urinary incontinence, hearing loss, arthritis, and coronary artery disease. She notes that she does not eat well and that she has lost weight and thinks that she is shorter. Vital signs are temperature 98.6°F (37°C), heart rate of 106 beats per minute, respiratory rate of 20 breaths per minute, blood pressure of 98/72, and pulse oximetry reading of 97%.

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