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The Case
This x-ray was taken on a 72-year-old man who presented to urgent care after falling off a step stool while trimming branches. He landed directly on his left shoulder and was unable to lift his arm over his head due to severe pain. He thought his shoulder was dislocated.

View the image taken (Figure 1) and consider what your diagnosis would be.

Clinical Challenge: November, 2014

Tracey Quail Davidoff, MD

Urgent care physician, BayCare Urgent Care, Florida. Editorial Board Member, the Journal of Urgent Care Medicine