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A 12-year-old boy, with a prior diagnosis of hereditary multiple exostoses, presented with sudden onset shortness of breath and chest pain. Physical examination and chest x-ray (CXR) revealed a large left tension pneumothorax. A chest drain was inserted and follow-up CXR showed complete resolution, allowing discharge 4 days later. The presence of multiple rib exostoses on CXR raised the possibility of pneumothorax occurring secondary to direct trauma from one such lesion. CT chest confirmed multiple bony exostoses and identified a causative lesion …
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