A 27-year-old right-handed male goes over the handlebars while mountain biking. On examination, there is swelling and deformity over the anterior aspect of his right shoulder. There is no "tenting" of the skin. There is pain and palpable crepitus on passive motion of the shoulder joint. Active shoulder elevation is limited by pain. Distal pulses are intact. There is no motor or sensory deficit over the right upper limb. Breath sounds are symmetrical. Xray shown below.
What is the most likely diagnosis?
A) Anterior shoulder dislocation
B) Posterior shoulder dislocation
C) Clavicular fracture
D) First rib fracture
E) Tension pneumothorax