Image diagnosis: a 16 year old with chest pain after blunt trauma.

Case Study A 16-year-old male developed chest pain immediately after he was tackled in a football game one hour before he presented to the Emergency Department. Examination of the chest wall revealed tenderness to palpation of the right proximal clavicle with a depression of the clavicular head (Figure 1). The patient had equal distal pulses and was neurovascularly intact with no airway compromise. Right clavicle series radiographs were obtained (Figure 2). A diagnosis of posterior sternoclavicular dislocation was suspected and confirmed by computed tomography scan (Figure 3). The underlying great vessels, esophagus, and airway were not compromised. The orthopedic service was consulted and subsequently performed an open reduction internal fixation as definitive management. The patient did not sustain damage to the underlying superior mediastinal structures and had an uneventful postoperative course.