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October 2007 Radiology Quiz
Answers due November 1st, 2007
Name: PGY:
This patient is a 33 year old male who presents to the ED with the chief complaint of shoulder pain after falling. The following x rays are shown.
Questions:
- Describe what you see?
- A lucency below the glenoid.
Diagnosis: Scapular neck fracture.
- What is the mechanism of injury?
- The mechanism of injury occurs when an anterior or posterior force is directed against the shoulder. In most patients, the glenoid will be impacted.
- 3. What would you find on physical exam?
- Patients usually present with their arm held in adduction and will resist all movement of the shoulder. The patient’s pain will worsen if medial pressure over the lateral humeral head is applied.
- 4. Associated injuries include:
- Proximal humerus fractures
- Shoulder dislocations
- Clavicle fractures
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5. What would be your management for this patient?
Nondisplaced: Shoulder immobilization, ice and analgesics
Displaced: These patients require an orthopedic consult for immediate reduction with skeletal traction. If the clavicle is fractured also, internal fixation of the clavicle should be performed as soon as possible. This will prevent the malunion of the scapular neck fracture.
6. Complications include:
Diminished shoulder mobility
- Trivia: “Monster Mash” is unquestionably the granddaddy of all Halloween pop songs. The singer, with his back-up group, created a number one hit in 1962 and then, in a rare move, the tune zoomed up U.S. charts again to number 10 in 1973. The back-up group was The Crypt Kickers, but who was the lead artist who adopted a middle nickname in reference to a classic horror film star?
- A: Bobby “Boris” Pickett.
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