How to tell difference between wrist sprain and fracture?

X-ry and follow up: If patient have fracture on the x-ray that is very clear , if have unclear fracture when you see him in about 2 weeks you see the fracture. Of course we apply splint on him in the meanwhile.

Exam and imaging: Wrist fractures may seen on standard x-rays and additional studies such as bone scan or MRI may be helpful sprains may be postivie finding in that here is no fracture but bones may be out of linel. A careful history and exam is also very important as you correctly implied it can be confusing so seek out so called experts such as a hand surgeon or orthopedic surgeon who specializes in han.