Intended for healthcare professionals

Endgames Spot Diagnosis

Breathlessness and neck swelling after a rugby game

BMJ 2017; 356 doi: (Published 02 February 2017) Cite this as: BMJ 2017;356:j311
  1. Oliver M J Gittoes, student1,
  2. Neil J L Gittoes, consultant and honorary professor2
  1. 1Bromsgrove School, Bromsgrove, Worcestershire, UK
  2. 2Centre for Endocrinology, Diabetes and Metabolism, Heritage Building, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK
  1. Correspondence to N Gittoes Neil.Gittoes{at}UHB.NHS.UK

A 16 year old boy presented to the emergency department with breathlessness and painful neck swelling after playing in a game of rugby. He had not sustained any trauma to the neck or chest. He had a history of asthma and had recently had an upper respiratory tract infection. His breathlessness was not helped by his salbutamol and he described the neck swelling and breathlessness progressively worsening since the match. What abnormalities are identified in the radiograph (fig 1) and what do they signify …

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