Which sign indicates a fracture in musculoskeletal examinations?

Bony tenderness is a critical indicator of a potential fracture during musculoskeletal examinations. When a bone is fractured, it often leads to localized pain directly over the affected area. This pain, characterized as bony tenderness, occurs because the fracture disrupts the bone's integrity, causing irritation of the surrounding nerves and soft tissues. The presence of tenderness specifically upon palpation of a bone strongly suggests a fracture rather than a soft tissue injury or other musculoskeletal condition.

In contrast, soft tissue tenderness may indicate injuries such as sprains or strains but is not definitive for fractures. Full range of motion typically suggests that there may not be a significant injury or fracture since a limitation in range of motion is often observed when a fracture is present. No edema implies there is little to no swelling, which can be atypical in cases of fractures where swelling is often present due to the inflammatory response to injury. Therefore, recognizing bony tenderness is essential for identifying fractures effectively.