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An Incidental Finding During Neuro Evaluation

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The radiograph shows a normal-appearing chest. Of note, though, is an anterior dislocation of the right shoulder. In addition, there is a fracture within the greater tuberosity of the right humerus.

Prompt orthopedic evaluation is obtained. In further discussion with the family, it was revealed that the patient had been experiencing falls recently; this injury was most likely the result of one.

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Nandan R. Hichkad, PA-C, MMSc

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Clinician Reviews - 25(3)
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brain tumor, consciousness, seizure, weakness, parasagittal mass, neurology, shoulder dislocation, dislocated shoulder, fracture, humerus
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Nandan R. Hichkad, PA-C, MMSc

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Nandan R. Hichkad, PA-C, MMSc

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ANSWER
The radiograph shows a normal-appearing chest. Of note, though, is an anterior dislocation of the right shoulder. In addition, there is a fracture within the greater tuberosity of the right humerus.

Prompt orthopedic evaluation is obtained. In further discussion with the family, it was revealed that the patient had been experiencing falls recently; this injury was most likely the result of one.

ANSWER
The radiograph shows a normal-appearing chest. Of note, though, is an anterior dislocation of the right shoulder. In addition, there is a fracture within the greater tuberosity of the right humerus.

Prompt orthopedic evaluation is obtained. In further discussion with the family, it was revealed that the patient had been experiencing falls recently; this injury was most likely the result of one.

References

References

Issue
Clinician Reviews - 25(3)
Issue
Clinician Reviews - 25(3)
Page Number
26,29
Page Number
26,29
Publications
Publications
Topics
Article Type
Display Headline
An Incidental Finding During Neuro Evaluation
Display Headline
An Incidental Finding During Neuro Evaluation
Legacy Keywords
brain tumor, consciousness, seizure, weakness, parasagittal mass, neurology, shoulder dislocation, dislocated shoulder, fracture, humerus
Legacy Keywords
brain tumor, consciousness, seizure, weakness, parasagittal mass, neurology, shoulder dislocation, dislocated shoulder, fracture, humerus
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Questionnaire Body
What does the chest radiograph reveal about this woman's right upper extremity weakness?

A 65-year-old woman is transferred to your facility from an outlying hospital for evaluation of a brain tumor. Family members found the patient sitting on the sofa, with a decreased level of consciousness. There was reported “seizure-type activity.” When she arrived at the outlying hospital, the patient was noted to have right-side weakness. Stat CT of the head demonstrated a fairly large parasagittal mass, and the patient was urgently transferred to your facility for neurosurgical evaluation. Primary survey on arrival shows an older female who is awake, alert, and in no obvious distress. Vital signs are normal. She has fairly pronounced right upper extremity weakness, more proximally than distally. Otherwise, the exam grossly appears normal. The patient’s initial imaging studies were sent with her on a CD. As you are trying to view the images of the brain, a chest radiograph pops up on your screen. What is your impression?
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