Chronic rib fractures with incidental subcutaneous glucose monitoring (CGM) sensor
Presentation
Blunt trauma. The patient fell and injured her left shoulder, chest and left elbow.
Patient Data
Dedicated shoulder X-rays excluded acute post-traumatic bony injury of the left shoulder. There is left glenohumeral and acromioclavicular osteoarthritis and age-appropriate bone density. There are left rib fractures which are suspected to be chronic and due to previous trauma/surgery with evidence of coronary artery bypass grafting with median sternotomy wires, mediastinal surgical clips and mitral valve annuloplasty.
There is an incidental, cutaneous, continuous glucose monitor (CGM) sensor applied to the posterior left shoulder.
Case Discussion
The rib fractures were considered chronic and non-united and likely due to previous trauma/surgery. In addition, no associated lung contusion, hemothorax, pneumothorax or surgical emphysema was present to suggest the rib fractures to be acute.
The left shoulder is intact with no acute post-traumatic bony abnormality.
There is an incidental continuous glucose monitoring (CGM) sensor applied to the typical recommended anatomical location of the posterosuperior upper limb soft tissues.
This is a FreeStyle Libre sensor device that is an example of a flash glucose monitoring system which monitors continuous interstitial glucose levels every minute and results are accessible on a linked smart mobile phone app. The device can be used by diabetic children and adults greater than 4 years of age and the waterproof sensor is replaced every 14 days.
Importantly the sensor must be removed prior to any MRI, CT or diathermy treatment.
Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.
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