Review Question - QID 212365

A 78-year-old woman is brought to the emergency department by her grandson after sustaining a fall. The grandson reports that the patient was walking into the living room when she tripped on a rug and landed on her right side. He denies witnessing convulsions or loss of consciousness. The patient did not hit her head nor have episodes of incontinence. She denies confusion, dizziness, chest pain, shortness of breath, or palpitations. She has a history of congestive heart failure. She takes lisinopril, carvedilol, spironolactone, and furosemide. Her temperature is 98.7°F (37°C), blood pressure is 138/91 mmHg, pulse is 108/min, respirations are 14/min, and oxygen saturation is 98% on room air. On physical examination, the patient appears anxious and frail. She holds her right arm in internal rotation. There is bruising on the lateral aspect of her right upper extremity. The range of motion of the right shoulder is limited by pain. A plain radiograph is obtained, as shown in Figure A. Which of the following may also be seen on physical exam?