Author: Mathew Bloch / Editor: Sarah Edwards / Codes: RP4, SLO4, TP3 / Published: 19/04/2023

A fit and healthy 52-year-old male walks into Emergency Department (ED) following a fall from a mountain bike onto his right shoulder and arm. He complains of a painful mass at the base of his neck.

His vital signs are normal and, apart from widespread abrasions, his only injury on examination is tenderness on palpation over his medial clavicle and a deformity as shown in the picture. His right arm is neurovascularly intact but he complains of medial clavicular pain on movement of his shoulder.