What clinical signs should I look for to confirm a diagnosis of a nasal fracture in a patient presenting after facial trauma?

To confirm a diagnosis of a nasal fracture in a patient presenting after facial trauma, look for the following clinical signs: visible deformity or asymmetry of the nasal bridge, swelling and bruising around the nose and periorbital area, tenderness on palpation of the nasal bones, nasal obstruction or difficulty breathing through the nose, epistaxis (nosebleed), and crepitus or mobility of nasal bones on gentle manipulation. Additionally, a septal hematoma may be present, characterized by a swollen, bluish, and tender nasal septum. These signs collectively indicate a likely nasal fracture and warrant further assessment or imaging if needed NICE NG232 Peeters et al. 2016Chukwulebe & Hogrefe 2019Landeen et al. 2022.