Abstract
A 34-year-old male with a history of quadriplegia following a spinal cord injury presented to the clinic endorsing persistent dry cough and mild chest pain for the past three weeks. The patient appeared comfortable, in no acute distress, and with stable vital signs during the visit. His physical exam was unremarkableexcept for no air movement in the right lung. An urgent in-house chest X-ray showed a large pneumothorax with a small layering fluid component and near-complete right lung collapse. The physical exam has been the cornerstone of medical practice since its inception. This tradition has been passed down from physician educators to learners for centuries. Our case is unique because patients with severe pneumothorax usually exhibit urgent symptoms, such as respiratory distress and desaturations at presentation. However, our patient presented with only mild non-specific symptoms and did not have significant risk factors.Therefore, performing a thorough physical exam is essential to help uncover life-threatening pathologies even in patients with no severe symptoms.
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