Radiology Review

Man Thrown From Balky Bike

Clinician Reviews. 2016 November;26(11):23,28
Author(s):
Nandan R. Hichkad, PA-C, MMSc
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Man Thrown From Balky Bike image

A 55-year-old man is brought to your facility following a motorcycle accident. He was a helmeted rider who was inadvertently thrown from the motorcycle when the accelerator got stuck. Bystanders reported he had brief loss of consciousness, but upon arrival to your facility, he is awake.

History is limited as the patient is confused and repetitive in his speech, indicating he is post concussive. He is complaining of head, face, and chest wall pain. His vital signs are all within normal limits; he is hemodynamically stable. His O2 saturation is 98% on room air. Breath sounds are clear.

As you are completing your primary survey, portable chest and pelvic radiographs are obtained. The chest radiograph is shown. What is your impression?


 

Man Thrown From Balky Bike image

ANSWER

The radiograph does not demonstrate any evidence of acute chest or intrathoracic injury. Of note, it appears that the left humerus is dislocated anteriorly and inferiorly.

Dedicated shoulder radiographs were obtained, which confirmed the dislocation with no evidence of fracture. Orthopedics was consulted for evaluation and subsequent reduction.

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