Post-Fall Pain: Do You Need X-rays for Potential Fractures? - Orthopedics

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I fell last week and hit my buttocks. It didn't hurt much at the time, but it still hasn't healed?


Hello, doctor.
Last week, I missed my step and fell from a height.
It hurt at first, but after a moment, the pain subsided.
I attended two physical education classes afterward and felt fine; there was no pain when sitting or lying down, but I did experience some pain when bending over.
I initially thought I would recover quickly, and after a week, I felt much better.
However, yesterday I started to feel a dull ache again, even though I didn't hit it or anything.
Today, after another physical education class, I noticed that bending over and even walking causes some pain, but sitting and lying down still don't hurt.
I'm wondering if there is a concern for a fracture.
If I go to see a doctor for an X-ray, will I need to remove my pants? I'm a bit scared.

Nihao, 10~19 year old female. Ask Date: 2023/12/12

Dr. Chen Yongxue reply Orthopedics


It is recommended to visit an orthopedic outpatient clinic for evaluation to avoid delaying treatment.
Please have a family member accompany you to the appointment.
Thank you.

Reply Date: 2023/12/12

More Info


After a fall, it is not uncommon to experience pain, especially if there was a significant impact or if you landed awkwardly. Your description of the pain being more pronounced when bending over and after physical activity suggests that there may be some underlying issue that needs to be addressed.
In general, when assessing whether to get X-rays after a fall, doctors often follow specific guidelines, such as the Ottawa ankle rules or the Canadian C-spine rules, which help determine if imaging is necessary based on symptoms and physical examination findings. If there is significant pain, swelling, or difficulty moving a joint, or if you have a history of osteoporosis or other risk factors for fractures, an X-ray may be warranted to rule out any fractures or serious injuries.

Given that you initially felt better after the fall and were able to participate in physical activities, it is possible that you may have sustained a minor injury, such as a sprain or strain, rather than a fracture. However, the recurrence of pain after a week, especially if it worsens with activity, raises some concern. It is essential to listen to your body; if the pain persists or worsens, seeking medical attention is advisable.

Regarding your concern about needing to undress for an X-ray, it depends on the area being examined. If the pain is localized to your lower back or hips, you may need to remove clothing that covers those areas. However, medical professionals are trained to ensure your comfort and privacy during examinations. They will typically provide a gown for you to wear during the X-ray process.

In conclusion, while it is possible that you may not have a fracture, the symptoms you are experiencing warrant further evaluation. An X-ray can help rule out any serious injuries and guide appropriate treatment. If you are unsure, it is always better to err on the side of caution and consult a healthcare professional. They can provide a thorough examination and determine the best course of action for your recovery. Remember, early intervention can often lead to better outcomes and prevent further complications.

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