Displaced comminuted left clavicle fracture with an associated large left supraclavicular, infraclavicular and anterior chest wall/axillary haemorrhage with the haematoma extending intercostally and extra pleurally adjacent to the mediastinal pleura. The first part of the left axillary artery is irregular and there is a large anterior pseudoaneurysm. The remainder of the axillary artery and brachial artery opacify normally. The left common carotid and right brachiocephalic artery are normal in appearance.
Trace of haemorrhage extending along the anterior upper mediastinal pleura. No periaortic haematoma. No traumatic aortic injury. No haemothorax or pneumothorax. Minor dependent lung changes, no pulmonary contusion or laceration.
Left posterior 5th to 8th minimally displaced rib fractures and anterior 5th to 7th rib fractures adjacent to the costochondral junction. No scapular or sternal fracture. Left sternoclavicular joint is asymmetrically widened raising suspicion for traumatic capsular injury. Normal thoracic spine.
IMPRESSION
Left axillary artery pseudoaneurysm and large surrounding haematoma.
Multiple left-sided rib fractures with 5th-7th rib flail segment. Comminuted and displaced left clavicle fracture. Suspected left sternoclavicular joint injury with no significant anterior or posterior subluxation.