Presentation
Right upper quadrant pain, worse on inspiration, and constipation ?obstruction
Patient Data
Age: 55 years
Gender: Male
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Normal bowel gas pattern. No plain radiographic evidence of obstruction, colitis or perforation.
Acute right 6th rib fracture.
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Magnified view of original abdo x-ray
Magnified view highlighting rib fracture from above study.
Case Discussion
Edge of film finding in a system that is not the predominant focus of the examination, in this instance a rib fracture on an abdominal examination. In the given history, this is likely to account for the patient's right upper quadrant pain.
This case highlights the importance of systematic review including edge of film and review of structures which are not the predominant focus of an exam.
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