This male patient presents to urgent care after, he claims, falling from a ladder. He refuses to give further details, except to say that the distance he fell was “not high.”
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.

Clinical Challenge: May, 2008

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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