Presentation
Mountain bike fall.
Patient Data
Age: 60 years
Gender: Male
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Displaced left 2nd rib fracture. Subpleural opacity at the left lung apex, probably extrapleural hematoma in the context of rib fracture. No pneumothorax. Elevation of the distal left clavicle.
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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 hematoma.
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.