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View the x-ray taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
The x-ray shows increased markings in the right mid-lung, which may be the first signs of a pulmonary contusion. This patient needs close follow-up.
The film reveals infiltrate in middle of right lung field suggestive of hematoma; no rib fracture was perceived.
The patient was discharged home with instructions to:
- rest
- follow up with her family physician the next day
- r/u CXR to recheck status of x-ray finding
- return immediately in the event of increased chest pain or
Acknowledgment: Case presented by Nahum Kovalski, BSc, MDCM.
Clinical Challenge: February, 2008
Nahum Kovalski, BSc, MDCM
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