A 40-year-old female is thrown from a horse at a point-to-point event. She lands on her left side and now has severe left upper quadrant abdominal pai...

Question

A 40-year-old female is thrown from a horse at a point-to-point event. She lands on her left side and now has severe left upper quadrant abdominal pain radiating to the left shoulder tip. She is tachycardic and looks pale. What is the significance of left shoulder tip pain in this context?

Accepted Answer

Kehr's sign - referred diaphragmatic irritation suggesting splenic injury with haemoperitoneum

Answer

Referred pain from a left rib fracture

Answer

Left rotator cuff injury from the fall

Answer

Pain from a left brachial plexus injury

Answer

Musculoskeletal pain from the landing mechanism

uk-dipimc MCQ (SBA): Kehr Sign and Splenic Injury

A 40-year-old female is thrown from a horse at a point-to-point event. She lands on her left side and now has severe left upper quadrant abdominal pain radiating to the left shoulder tip. She is tachycardic and looks pale. What is the significance of left shoulder tip pain in this context?