Project Description

A Painful Awakening

A three year old girl was brought to our ED because she fell out of bed while sleeping. She fell approximately 50cm and landed on her right side. Since that accident she has been crying, holding her head to the left and complaining of neck pain. After application of Fentanyl and Midazolam the paramedics were able to put her head in a neutral position and the girl was transported to our hospital by ambulance.

The clinical examination was challenging, however, her right clavicle seemed to be painful.

The following x-rays were performed.

Examinations

What is your next diagnostic step?