Orris
attachment
attachment

Completely analyse the x ray

analyse_media
Reading File
Reading File
Reading File
Finding Sources
Searching PubMed

clavicle fracture

Searching the Web

ACR Appropriateness Criteria acute shoulder pain radiographs clavicle fracture

Reading File
Finding Sources
Reading Web Page

https://acsearch.acr.org/docs/69433/narrative

Reading File

Preliminary image review

This is a left shoulder/clavicle radiograph photographed from a film, not the original diagnostic image. The photo angle, glare, and only one projection limit accuracy, so this is not a replacement for an official radiology report or orthopaedic examination.

Main visible finding

  • There appears to be a fracture through the mid to outer portion of the left clavicle (collarbone).
  • The fracture fragments appear displaced and overlapped/shortened. The inner (medial) fragment appears relatively elevated, with the outer (lateral) fragment lower.
  • The degree of displacement cannot be measured reliably from this photograph, but it looks more than minimally displaced.

Joints and adjacent bones

  • Glenohumeral joint: The humeral head appears located in relation to the glenoid. I do not see an obvious shoulder dislocation on this single view.
  • Proximal humerus/scapula: No clear additional major fracture is visible on the photographed film, though assessment is limited.
  • AC joint: No definite gross acromioclavicular separation is apparent, but this cannot be confidently excluded from this view/photo.
  • Chest/ribs: The visible upper left ribs do not show a definite acute fracture, but they are only partly included.

Impression

Likely displaced left clavicle shaft fracture. The overlap and displacement mean this needs prompt in-person orthopaedic assessment, rather than simply self-treating as a minor injury.
Dedicated upright clavicle views, including a cephalad-tilt view, are used to assess displacement and shortening more accurately. If clinically needed, the clinician may request repeat X-rays or CT. Rockwood and Green's Fractures in Adults, 10th ed., p. 1197. The ACR shoulder-trauma guidance also supports further targeted imaging when the initial assessment is incomplete or concerning.

What to do now

  • Use a sling and avoid lifting, pushing, pulling, or overhead movements with the left arm.
  • Arrange urgent orthopaedic review, ideally today or within 24-48 hours, especially if this is a fresh injury.
  • Take the original X-ray or digital images and report with you.
  • Treatment may be sling-based or surgical depending on clinical examination, skin condition, shortening/displacement, fracture pattern, activity needs, and follow-up imaging. An X-ray photo alone cannot determine whether surgery is needed.

Go to emergency care immediately if any of these apply

  • Skin over the collarbone is stretched, whitened, or looks as if bone may pierce it
  • An open wound or bleeding near the fracture
  • Increasing swelling, severe uncontrolled pain, chest pain, breathing difficulty
  • Arm/hand becomes numb, weak, pale, cold, or blue
  • Major trauma such as a high-speed road collision or fall from height
A recent evidence review also highlights that associated AC-joint injury can coexist with midshaft clavicle fractures, so the shoulder examination and complete imaging matter (systematic review, PMID 40022180).

In my opinion the ribs are also fractured under the clavicle

Reading File
Finding Sources
Searching PubMed

rib fractures radiography

Searching the Web

ACR Appropriateness Criteria rib fractures chest radiography CT trauma

It is reasonable to question the ribs, but I cannot confirm a rib fracture from this photographed shoulder film.
The area immediately under the clavicle contains overlapping structures: the upper ribs, scapula, soft tissues, and parts of the lung. On this single, angled photo, I do not see a definite displaced rib break, but subtle or nondisplaced upper-rib fractures can easily be hidden. A dedicated chest X-ray or CT, selected based on the injury mechanism and symptoms, is needed to settle it.
The left clavicle fracture remains the clearer abnormality. Because upper-rib fractures can coexist with clavicle trauma, particularly after significant force, the treating clinician should examine the chest and review formal images. Rockwood and Green's Fractures in Adults, 10th ed., p. 1196. Standard chest radiography is usually the initial test for suspected rib injury, while CT is more sensitive and is mainly considered when the trauma is substantial or there is concern for internal injury, as summarized in the ACR rib-fracture guidance.
Please seek urgent assessment today if there is:
  • Pain on breathing, shortness of breath, cough, or chest tightness
  • Worsening pain over the upper chest/ribs
  • Faintness, rapid heartbeat, or coughing blood
  • Major trauma, especially a road-traffic crash or fall from height
Ask for the official radiology report and a chest examination/X-ray if rib pain or breathing symptoms are present.
This is a shared conversation. Sign in to Orris to start your own chat.