|David's x-ray with depression top left|
David appeared quite well and I could only find some minor scratches on his head with no swelling. His mother could not remember him hitting his head when he was younger. I elected to obtain a lateral skull x-ray since I could not find a depression on his skull to go with his x-ray finding. The additional x-ray also showed the depressed skull fracture. By then David's father arrived and remembered David had fallen out of a Mango tree as a young child.
|David with Parents|
Conclusion: Indeed David had sustained a depressed skull fracture, but as a child and not 2 days earlier from the falling tree.
David's case is a good reminder to treat the patient and not necessarily the lab or x-ray finding.