Author: Aditya Dave, MD
Co Author #1: Christian Schupp, MD
Co Author #2: Christian Schupp, MD
Co Author #3: Christian Schupp, MD
Senior Editor: Kevin Gray, MD
Editor: Andrew McBride, MD

Patient Presentation:
A 15-year-old Wide Receiver with right clavicle pain that was ongoing for two days.

History:
A 15-year-old Wide Receiver presented to our outpatient sports medicine clinic with right clavicle pain that was ongoing for two days. Patient was injured at a football game two days prior, when he was tackled and fell backwards. Ever since then, he had pain along the right middle clavicle to sternoclavicular joint. He initially went to the emergency room the day of the injury where an X-Ray was done which showed mild angulation of the clavicle that could represent a plastic bending or nondisplaced fracture. He was treated as an acute clavicle fracture, placed in a sling, and told to follow up with sports medicine. He was seen in clinic two days later and was compliant with the sling and only removed it to sleep. He took over the counter acetaminophen for pain without relief. He denied any shortness of breath, discoloration of extremities, dysphagia, or tachypnea.

Physical Exam:
Blood Pressure: 121/83, Pulse: 67, Height: 5 ft 11 in, Weight: 77.1 Kg (170 lbs.)

Constitutional: General: No acute distress, not ill appearing, non toxic, no diaphoresis
Pulmonary: Pulmonary effort normal. Normal breath sounds
Chest Wall: Deformity, swelling, and tenderness along the right sternoclavicular joint. No laceration or crepitus
Musculoskeletal: Tenderness and depression of the right sternoclavicular joint. Decreased active range of motion of the right shoulder.
Skin: Skin warm, without any jaundice or pallor. No bruising, erythema, tenting, lesion or rash

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.