SA JOURNAL OF RADIOLOGY  •  June 2011     63

QUIZ CASE

Presentation
A chronically ill 49-year-old woman presented to the trauma unit with acute on chronic right arm pain after a syncopal episode. The following 
radiographic images were obtained (Figs 1 - 3).

At subsequent follow-up, plain radiography and an ultrasound scan were performed. Figs 4a and 4b are plain abdominal radiographs, and Fig. 5 is 
a gallbladder sonar image.

Findings
Describe the relevant findings and provide the most appropriate clinical diagnosis. Please submit your response to shalendramisser@hotmail.com 
before 29 July 2011. The winning respondent will receive a R1 000 award from the RSSA. A detailed diagnosis and discussion will appear in the next 
issue of the SAJR.

Arm pain after syncope
S K Misser, MB ChB, FCRad (D)
Lake Smit and Partners, Durban

Corresponding author: S Misser (shalendramisser@hotmail.com)

Fig. 1. Lateral chest radiograph. Fig. 2. Antero-posterior view of the right 
shoulder.

Fig. 3. Antero-posterior view of the 
right tibia.

Fig. 4a Fig. 4b Fig. 5