Submitted by Jonathan Frankel, MD, and Thomas J. Learch, MD.
History of Present Illness
- 70-year-old female presented to the ED three days after she was hit by her phone on the left side of her forehead.
- She denied any loss of conciousness or vomiting, but she had persistent headaches.
- Past medical history: asthma, GERD, COPD, HTN, migraines.
- Past surgical history: dental reconstruction, TAH BSO for fibroids.
Physical Exam and Laboratory Work
- Patient reported only pain in her midline forehead.
- All lab work was within normal limits.
- A CT brain as ordered for further evaluation and was normal intracranially. The following were osseous findings incidentally identified.
What subtle osseous finding was noted?
- Osseous metastatic disease
- Skull fracture.
- Hematopoietic bone marrow expansion
- Thinning of the bilateral parietal skull
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