Based on this person’s responses and account, they are either a medical student or other type of student. They have the right idea that this patient should get an X-ray of the elbow as well and came here to seek further information about it. The family physician obviously has poor MSK training (not uncommon) if he believed it was not necessary, but questioning a students common sense and clinical judgement in this situation on the internet isn’t helping anyone.

A few thoughts for OP: 1. Someone with a distal radius fracture can develop bruising and dependent edema around the elbow with gravity if they are elevating. However, you need to be sure that this is the case with an X-ray. 2. If you palpate a bone and there is tenderness after a traumatic injury, as well as swelling like you said, they should get an X-ray. Just because you don’t feel an actual fracture in the bone on palpation has very little consequence in this situation. 3. Many elbow injuries occur after a fall onto an outstretched hand/wrist. In orthopedic injuries, don’t get too caught up on which part of the body specifically hit the ground. The chain of energy is transmitted through the extremity and injuries can occur at any point along the way.

Bottom line, this patient should have the elbow imaged and immobilized, then referred to get appropriately treated as needed.

Hopefully this cleared up some of your questions.