How is a clavicle fracture in a baby diagnosed?

Pseudo paralysis. Clavicle fracture in a baby is suspected in large babies following a difficult vaginal delivery. There may be a muffled crepitus when pressing over the clavicle. Many times the baby will not spontaneously move the affected arm.
Tenderness. The fracture site will be painful even in babies. (they may cry or grimmace) sometimes they won't use the affected arm and finally on exam you can feel the break it is called crepitence.