Presentation
Mountain bike fall.
Patient Data



Displaced left 2nd rib fracture. Subpleural opacity at the left lung apex, probably extrapleural haematoma in the context of rib fracture. No pneumothorax. Elevation of the distal left clavicle.





Asymmetric widening of the left acromioclavicular joint with mild elevation of the distal clavicle but not beyond the superior border of the acromion (Rockwood type 2 injury). Left 2nd rib fracture and subpleural opacity, probably representing extrapleural haematoma.
Case Discussion
Interrogating all parts of the image is important - there are peripheral injuries on both the chest x-ray and the shoulder x-ray, which could be easily missed with a satisfaction of search error.