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Subclavian vascular injury — RCPSC EM MCQ

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EasyTraumaSubclavian vascular injuryRCPSC EM

A 30-year-old snowboarder lands on his shoulder. He has severe clavicular pain, hoarseness and an expanding supraclavicular haematoma. Radial pulse is present but weaker than the other side; chest radiograph shows a first-rib fracture. What is the most likely diagnosis?

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Correct answer: D — Subclavian vascular injury

First-rib fracture with expanding haematoma, voice change and pulse asymmetry suggests major vascular injury. CT angiography and trauma/vascular consultation are required.

Reference: ATLS; Canadian vascular trauma principles