Teen With Dyspnea After Chest Wall Trauma

May 15, 2015

X-rays offer no clue to the cause of dyspnea in this teen who cannot take a deep breath after crashed on his bicycle. Watch the short video, read the clues, and make your diagnosis.

This 17-year-old is unable to take a deep breath after sustaining chest wall trauma during a bike crash. Now, in the ED, he is afebrile; heart rate: 69 beats/min; respiratory rate, 55 breaths/min; BP, 126/87 mmHG; SpO2, 99% on nonrebreather mask. He is otherwise healthy and takes no medications. The initial radiograph was read as normal by the radiologist.

What do you suspect is the cause of the dyspnea?