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Is there a good way to determine if something is a break or just a strain?

A painful extremity can be very misleading! Generally, without obtaining an x-ray of the area, it will not be possible to ascertain if the pain is due to a strain or fracture (break). The old advice of “if I can move it, it’s not broken,” generally is false. Quite often we discover a fracture even though someone can move a painful finger, wrist, foot or ankle.