Hi doctor,Yesterday I was walking and tripped, resulting in a facial injury from concrete. The point of impact was my nose, and aside from several cuts, I am unsure if it is broken. It is not crooked at all and did not even bleed when the incident occurred. But it is quite swollen and hurts to touch. I blew my nose this morning and there was a bit of blood. I have also had a few headaches. Should I go get it checked out or am I fine?
Hello. You have sustained some bruise and possibly internal injury over the bony dorsum of the nose. This is the area of nasal bones, their suturing with each other and their junction with the frontal bone (forehead bone).  If you were to come to me, I would check for crepitus and palpate the whole area for any deformity, step change, tenderness, bubbles feeling, etc. It may be difficult for you to do on your own and arrive at right inferences. Next, what I would do is to get a CT scan of nose and sinuses. If a CT is not available or not feasible, we can go for a plain radiograph of nasal bones. However, a CT is preferred. The radiological investigation whether CT or X-ray will help us know whether there is any fracture of nasal bone or septum or orbital margins or rim and if there is any collection of fluid or inflammation. Depending on that we can tailor our treatment. If there is a Y-fracture, we correct immediately. Suppose it is more than 48 hours after sustaining the injury, then we wait for two weeks for healing to get over and then subsequently plan a rhinoplasty surgery to correct any remnant deformity. Right now there is swelling and so we cannot infer anything concrete without doing an investigation. Hence go ahead and get the investigation and we shall help you on how to go about with it. Since you are 18 years old and the nose is a prominent area of the face and very importantly concerned with the overall beauty of the face, I would suggest you go and get the tests done and follow up with us. Till then, to relieve pain Tylenol (Paracetamol) as per your weight, taken twice or thrice daily. To relieve edema take Trypsin-Chymotrypsin-Rutopside-Bromelain combination which is anti-inflammatory and helps relieve edema of the nose. For more information consult an ENT otolaryngologist online -->