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Image challenge: acute chest pain after tooth extraction
  1. Sheeba Zaheer,
  2. Sivasubramanian Srinivasan,
  3. Mohamad Isham Othman
  1. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore
  1. Correspondence to Dr Sivasubramanian Srinivasan; sivasu2{at}

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Clinical introduction

A previously healthy 55-year-old woman presented to the ED with chest discomfort. She underwent wisdom tooth extraction the same morning, during which she experienced discomfort over the right side of neck, which gradually spread to the right and central chest region, and was associated with discomfort while breathing. On examination, there was tenderness over the neck and chest. Range of motion of the neck was limited due to pain. Her vitals were stable, and the rest of the physical examination was unremarkable.

A frontal chest radiograph was obtained (figure 1).

Figure 1

Initial chest radiograph.


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  • Contributors SZ: Obtaining patient consent, writing up the details of case and selecting images. SS: Discussion and images. MIO: Discussion.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.