Scapular fracture (incidental)

Case contributed by Andrew Murphy
Diagnosis certain

Presentation

Confusion, evidence of a perfusion mismatch on VQ scan - chest x-ray to rule out any infection contributing to delirium.

Patient Data

Age: 80 years
Gender: Female
x-ray

Incidental comminuted fracture of the right scapula.

Subsequent imaging

x-ray

Comminuted fracture of the right scapula extending from the inferior medial border to the lateral margin of the scapular spine.

Case Discussion

This case demonstrates the value of scrutinising all elements of the chest radiograph despite any given clinical history. As the patient was non-communicative a clinical history was hard to establish.

The shoulder imaging was performed hours after the initial chest radiograph.

Following these findings, it was confirmed the patient had suffered a fall without recollection and subsequently revealed her pain related stressor. 

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