An 18-year-old male presents following after a high-speed motorbike accident (MBA) in which he was thrown into a pole at whilst wearing a helmet.

On arrival he was haemodynamically stable with a GCS of 14. He has extensive grazes to his left shoulder and marked left upper arm swelling.

Following the primary survey it was noted that he had an absent left radial and brachial pulse. Bedside doppler could detect left upper limb pulses and the hand was warm. However there was minimal motor function in the left upper limb.

A CXR and Left shoulder X-ray were taken in the resuscitation bay


Describe and interpret the X-rays

The patient is subsequently taken for CT.

Describe and interpret the CT scans
Clinical Pearls

References

TOP 100 CT SERIES


Dr Parvathy suresh kochath LITFL Author

Provisional fellow in emergency radiology, Liverpool hospital, Sydney. Other areas of interest include paediatric and cardiac imaging.

Dr Georgina Beech LITFL Author

Emergency Medicine Education Fellow at Liverpool Hospital NSW. MBBS (Hons) Monash University. Interests in indigenous health and medical education. When not in the emergency department, can most likely be found running up some mountain training for the next ultramarathon.

Dr Leon Lam LITFL Author 2

Dr Leon Lam FRANZCR MBBS BSci(Med). Clinical Radiologist and Senior Staff Specialist at Liverpool Hospital, Sydney

Dr Jenni Davidson LITFL Author

Sydney-based Emergency Physician (MBBS, FACEM) working at Liverpool Hospital. Passionate about education, trainees and travel. Special interests include radiology, orthopaedics and trauma. Creator of the Sydney Emergency XRay interpretation day (SEXI).

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