Motor vehicle accident.
Central chest pain worse with inspiration and movement with sternal tenderness.
There is a clear step visible in the outer cortex of the mid sterum. This corresponds to the area of maximal tenderness and is consistent with a transverse fracture of the sternum at this level.
With each respiratory cycle separate movement of the cephalad and caudal fracture components is evident indicating this fracture extends through both cortices.
This is the the characteristic ultrasound appearance of a transverse sternal fracture involving both cortices of the sternum.