11th January 2024

An 83-year-old lady presents to the Emergency Department following a fall at home 24 hours ago with an associated chest and head injury.

An 83-year-old lady presents to the Emergency Department following a fall at home 24 hours ago with an associated chest and head injury. She has an extensive past medical history, including dementia, atrial fibrillation, previous myocardial infarction, previous stroke and chronic venous insufficiency. She complains of significant pain in her chest following the fall. An x-ray shows non-displaced fractures of the right 5th, 6th and 7th ribs with an associated pleural effusion. A bedside ultrasound is completed, which shows a loculated pleural effusion on the right. 

Given the appearance of the pleural fluid on diagnostic imaging, what is the most likely cause of the pleural effusion?

Select the SINGLE most appropriate option from the list below. Select ONE option only.