Note in the image above, within the red circle, there is a oval shaped calcified area. Given his age, and history (back pain with minimal trauma), the answer of course is...
The old saying goes that the most common fracture you miss on X Ray is the second one (because you are so focused on the first). Similarly, we frequently miss the things we are not primarily looking for. This calcified area measured around 10 cm, and was concerning for a possible AAA. This X ray was ordered to evaluate for traumatic injury causing back pain. Make sure to fully evaluate you radiographs. Look at everything, and come up with comprehensive, reproducible ways of evaluating your images. More on this as the weeks go on.
An 8 year old girl is brought in for evaluation after falling off of her bicycle. She complains of abdominal pain, and states she thinks she went over the handlebars when she fell. On exam, you note abdominal tenderness in the upper abdomen, and see the findings in the image below. What is the next step in the workup of this patient? What labs, if any, should be ordered? What are the classic diagnoses of concern in this injury mechanism?