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- W2953896319 abstract "HISTORY: 17 year old high school football wide receiver presented with left back and rib pain. He sustained a hit in that region during a football game the night before. He was taken out of the game due to pain and difficulty breathing which ultimately kept him from finishing the game. After the game he continued to have pain for which he took a muscle relaxant that he had from a previous injury and over the counter pain medication with minimal pain relief. The pain persisted through the night and into the following morning. His pain was worse with deep breathing and any pressure on his chest. He denied any shortness of breath, dyspnea with exertion, cough, wheezing or hemoptysis. PHYSICAL EXAMINATION: Appeared in no acute distress, Ecchymosis over the posterior lateral aspect of left lower ribs with tenderness to palpation, No crepitus, No palpable deformity, Symmetric chest expansion, posterior rib/back pain reproduced with deep inspiration, Equal bilateral breath sounds, No hyper-resonance to percussion, Normal respiratory rate, Negative anterior posterior compression test, Positive lateral compression test, Full AROM of the back DIFFERENTIAL DIAGNOSIS: Rib fracture, Pneumothorax, Pulmonary contusion, Pulmonary embolism TEST AND RESULTS: X-ray Rib series: Small left apical pneumothorax involving approximately 20% of the hemi thorax. Suspected nondisplaced fractures involving the posterolateral left eighth and ninth ribs with small linear lucencies within these regions. Chest CT scan: Small left-sided pneumothorax approximately 20%. No acute osseous injury. FINAL WORKING DIAGNOSIS: Pneumothorax TREATMENT AND OUTCOMES: The patient was sent to ER after being seen in clinic to expedite getting a CT scan done after the X-rays. After the CT scan was obtained it was decided by the ED to admit the patient for observation. He obtained a subsequent x-ray that evening 12 hours after is initial which showed a slightly smaller left apical pneumothorax. He was discharged the next day. Repeat chest x-ray done three days after discharge showed improving pneumothorax. Patient was seen in clinic 2 weeks after his discharge from the hospital and was started on a graded exercise program with repeat x-ray at 1 week after clinic visit showed resolution of pneumothorax. He returned to full game play at 4 weeks after his initial injury." @default.
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- W2953896319 date "2019-06-01" @default.
- W2953896319 modified "2023-09-27" @default.
- W2953896319 title "Chest Injury-football" @default.
- W2953896319 doi "https://doi.org/10.1249/01.mss.0000561854.47314.3e" @default.
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