Elderly Woman Takes a Fall

A 90-year-old woman is complaining of pain on the left side of her face, her chest wall, and right shoulder. Her family reports that she has fallen multiple times recently. On one occasion, there was brief loss of consciousness. History is significant for hypertension and osteoarthritis. Initial examination indicates she is awake, alert, oriented, and in no obvious distress. Vital signs are stable, and breath sounds are clear. There is tenderness on the left side of her face and decreased range of motion in her right shoulder, as well as localized tenderness. The hospitalist ordered a chest radiograph when the patient was admitted. What is your impression?