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Breathtaking Blitz - Page #1

Author: Ashley McCurdy, DO Co Author #1: Hunter Chamma Co Author #2: Rebecca Skains Senior Editor: Kristine Karlson, MD, FAMSSM Editor: Naga Sai Venkata Madhavapeddi, MD Patient Presentation: A 23-year-old male presented with complaints of altered voice, right ear fullness, and right scapula pain. History: A 23-year-old male Division I quarterback presented postgame with complaints of altered voice, right ear fullness and right scapula pain. He complained of right shoulder/scapula pain that started during the game after he was involved in several hard tackles which were treated by the athletic trainer (AT) and massage therapist on the sideline. Postgame, he followed up with the AT who noted some right ear fullness and requested the team physician to evaluate the athlete. Physical Exam: Upon initial evaluation by the physician, the athlete was alert, oriented and presented with unlabored breathing. He was not in any distress. However, his voice was altered. Upon palpation, subcutaneous emphysema was noted over his anterior neck extending from the right posterior auricular area to the right 10th rib and across his anterior chest to the left 4th rib. His trachea was midline and no bony tenderness was appreciated across the ribs, clavicles, scapulae, humeri, or spine. Exam was also positive for tissue texture change, asymmetry, restriction of motion and tenderness around the right scapula and cervical spine. The athlete was sent to the local Emergency Department (ED) for further evaluation of his diffuse right sided subcutaneous emphysema. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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