Adult Male With Chest Pain After a Fall

A 61-year old man presented to the emergency department with chest pain shortly after a fall from a ladder. The patient was alert and in no significant distress, with normal vital signs. There was tenderness on the left lateral chest wall. A fullness was noted over the right anterior chest and crepitus was palpable on the right lateral chest wall. He also had diminished breath sounds on the right. Chest radiograph (Figure 1) showed a large right-sided pneumothorax (blue arrows) and subcutaneous air pockets in the right lateral chest wall (yellow arrow).

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