Is my daughters nose broke despite the x-rays coming back negative?

Question

My daughter had a bad fall 4 days ago. We saw a doctor right away to see if it was broken and he said yes. He sent us for x-rays the next morning and we got the results back that it wasn't. 4 days later it is still bent to the left and bruised very bad. Today she got 2 black eyes. Should I get a second opinion?

Kenneth Hughes, MD · Answer

You should be examined by a surgeon to determine how to manage the nose.Kenneth Hughes, MDLos Angeles, CA

Larry C. Leverett, MD, FACS · Answer

Yes, it should be re-evaluated. A negative imaging study doesn't guarantee that you don't have a fracture. Also, repairing it soon makes the surgery A LOT easier than allowing the fracture to heal in an undesireable form.

Steven Wallach, MD · Answer

If the nose looks displaced with a bump or off-center and looks different than before the accident, it is likely fractured. X-rays amy miss it, and cartilage fractures do not project on x-rays too well if at all.

William Portuese, MD · Answer

Even though the nasal bones do not appear fractured on the x-ray, cartilage can become fractured and displaced away from the bones themselves. Cartilage grafting such as a spreader graft may be required if the upper lateral cartilage has been fractured off the nasal bone. It is best to have this done within the first month after the injury, rather than waiting  for it to heal crooked. For many examples please see the link below

Karol A. Gutowski, MD, FACS · Answer

An x-ray is typically not needed to diagnose a broken nose. Go see a plastic surgeon or facial plastic surgeon as soon as possible for an evaluation. The bones may not be broken but the cartilage may be damaged and cause the nose to look bent to one side - this will not show up on an x-ray. If you wait too long, it is harder to fix and get insurance to cover it.

Richard W. Fleming, MD (retired) · Answer

If your daughter's nose looks different than it did before the accident or breathing is obstructed after the swelling resolves, it is broken. Broken cartilage does not show up on routine x-rays; your physician's examination is much more reliable.

Is my daughters nose broke despite the x-rays coming back negative?

Answers (6)

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