7th rib fracture due to blunt trauma
Diagnosis certain
Updates to Case Attributes
Presentation
was changed:
Blunt trauma to right lower anterior chest wall at a football match. Complaining of local pain.
Age
changed from 38 to 38 years.
Body
was changed:
Rib fractures are the most common (25%) injuries resulting from blunt chest trauma and are usually revealed on plain radiographs. RadiographyHowever, radiography sometimes may not show fractures, especially those in nondisplaced fractures and costal cartilage fractures,.
CT is the gold standard technique for showing rib fractures. However, cartilage fractures can be easily overlooked when focusing on bony fractures or pulmonary parenchymal tissue and also doesn't show up in the commonly used bone window 3D volume rendering.
In the literature, the usefulness of USGultrasonography (USG) in detecting rib fractures varies widely: from not significant to more sensitive than radiography.
The greatest advantage of USG is the ability to directly explore the tender point by asking the patientto pin-point the most painful rib during the examination..
In patients presenting with blunt chest trauma, USG can provide a prompt means to confirm or rule out associated findings such as pleural effusion, pneumothorax and hemothorax.
On the other hand, the advantages of USG includinginclude non-invasiveness, portability, relative inexpensiveness, lack of radiation, and repeatability, makemaking it a valuable diagnostic tool.
In the paediatric population and pregnants USGpregnant women, USG may be preferable.
This case shows the importance of USG in the evaluation of rib fracture esspeciallyfractures, especially in minor or mild blunt chest trauma.
-<p>Rib fractures are the most common (25%) injuries resulting from blunt chest trauma usually revealed on plain radiographs. Radiography sometimes may not show fractures, especially those in nondisplaced fractures and costal cartilage fractures,</p><p>CT is the gold standard technique for showing rib fractures. However, cartilage fractures can be easily overlooked when focusing on bony fractures or pulmonary parenchymal tissue and also doesn't show up in the commonly used bone window 3D volume rendering.</p><p>In the literature, the usefulness of USG in detecting rib fractures varies widely: from not significant to more sensitive than radiography.</p><p>The greatest advantage of USG is the ability to directly explore the tender point by asking the patient to pin-point the most painful rib during the examination..</p><p>In patients presenting with blunt chest trauma, USG can provide a prompt means to confirm or rule out associated findings such as pleural effusion, pneumothorax and hemothorax.</p><p>On the other hand, the advantages of USG including non-invasiveness, portability, relative inexpensiveness, lack of radiation, and repeatability, make it a valuable diagnostic tool.</p><p>In paediatric population and pregnants USG may be preferable. </p><p>This case shows the importance of USG in the evaluation of rib fracture esspecially in minor or mild blunt chest trauma</p>- +<p>Rib fractures are the most common (25%) injuries resulting from blunt chest trauma and are usually revealed on plain radiographs. However, radiography sometimes may not show fractures, especially in nondisplaced fractures and costal cartilage fractures.</p><p>CT is the gold standard technique for showing rib fractures. However, cartilage fractures can be easily overlooked when focusing on bony fractures or pulmonary parenchymal tissue and also doesn't show up in the commonly used bone window 3D volume rendering.</p><p>In the literature, the usefulness of ultrasonography (USG) in detecting rib fractures varies widely from not significant to more sensitive than radiography.</p><p>The greatest advantage of USG is the ability to directly explore the tender point by asking the patient to pin-point the most painful rib during the examination.</p><p>In patients presenting with blunt chest trauma, USG can provide a prompt means to confirm or rule out associated findings such as pleural effusion, pneumothorax and hemothorax.</p><p>On the other hand, the advantages of USG include non-invasiveness, portability, relative inexpensiveness, lack of radiation, and repeatability, making it a valuable diagnostic tool.</p><p>In the paediatric population and pregnant women, USG may be preferable. </p><p>This case shows the importance of USG in the evaluation of rib fractures, especially in minor or mild blunt chest trauma.</p>
References changed:
- 1. Mattox R, Reckelhoff KE, Welk AB, Kettner NW. Sonography of occult rib and costal cartilage fractures: a case series. (2014) Journal of chiropractic medicine. 13 (2): 139-43. <a href="https://doi.org/10.1016/j.jcm.2014.06.008">doi:10.1016/j.jcm.2014.06.008</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25685124">Pubmed</a> <span class="ref_v4"></span>
- 1. Mattox R, Reckelhoff KE, Welk AB, Kettner NW. Sonography of occult rib and costal cartilage fractures: a case series. (2014) Journal of chiropractic medicine. 13 (2): 139-43. <a href="https://doi.org/10.1016/j.jcm.2014.06.008">doi:10.1016/j.jcm.2014.06.008</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/25685124">Pubmed</a> <span class="ref_v4"></span>
- 2. Kara M, Dikmen E, Erdal HH, Simsir I, Kara SA. Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. (2003) European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 24 (4): 608-13. <a href="https://www.ncbi.nlm.nih.gov/pubmed/14500082">Pubmed</a> <span class="ref_v4"></span>
- 2. Kara M, Dikmen E, Erdal HH, Simsir I, Kara SA. Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. (2003) European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 24 (4): 608-13. <a href="https://www.ncbi.nlm.nih.gov/pubmed/14500082">Pubmed</a> <span class="ref_v4"></span>
- 3. Turk F, Kurt AB, Saglam S. Evaluation by ultrasound of traumatic rib fractures missed by radiography. (2010) Emergency radiology. 17 (6): 473-7. <a href="https://doi.org/10.1007/s10140-010-0892-9">doi:10.1007/s10140-010-0892-9</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20652719">Pubmed</a> <span class="ref_v4"></span>
- 3. Turk F, Kurt AB, Saglam S. Evaluation by ultrasound of traumatic rib fractures missed by radiography. (2010) Emergency radiology. 17 (6): 473-7. <a href="https://doi.org/10.1007/s10140-010-0892-9">doi:10.1007/s10140-010-0892-9</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20652719">Pubmed</a> <span class="ref_v4"></span>
- 4. Pishbin E, Ahmadi K, Foogardi M, Salehi M, Seilanian Toosi F, Rahimi-Movaghar V. Comparison of ultrasonography and radiography in diagnosis of rib fractures. (2017) Chinese journal of traumatology = Zhonghua chuang shang za zhi. 20 (4): 226-228. <a href="https://doi.org/10.1016/j.cjtee.2016.04.010">doi:10.1016/j.cjtee.2016.04.010</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28687342">Pubmed</a> <span class="ref_v4"></span>
- 1) R. Mattox, K.E. Reckelhoff, A.B. Welk, N.W. KettnerSonography of occult rib and costal cartilage fractures: a case seriesJ Chiropr Med, 13 (2014), pp. 139-143, 10.1016/j.jcm.2014.06.008 2)M. Kara, E. Dikmen, H.H. Erdal, N.W. KettnerDisclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma Eur J Cardiothorac Surg, 24 (2003), pp. 608-613 3)F. Turk, A.B. Kurt, S. Saglam Evaluation by ultrasound of traumatic rib fractures missed by radiographyEmerg Radiol, 17 (2010), pp. 473-477, 10.1007/s10140-010-0892-9 4) Comparison of ultrasonography and radiography in diagnosis of rib fracturesElhamPishbinaKooroshAhmadibMoloodFoogardic MaryamSalehid FarrokhSeilanian Toosie VafaRahimiMov https://doi.org/10.1016/j.cjtee.2016.04.010
- 1. R. Mattox, K.E. Reckelhoff, A.B. Welk, N.W. Kettner. Sonography of occult rib and costal cartilage fractures: a case series. J Chiropr Med, 13 (2014), pp. 139-143, 10.1016/j.jcm.2014.06.008
- 2. M. Kara, E. Dikmen, H.H. Erdal, N.W. Kettner. Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. Eur J Cardiothorac Surg, 24 (2003), pp. 608-613.
- 3. F. Turk, A.B. Kurt, S. Saglam. Evaluation by ultrasound of traumatic rib fractures missed by radiography. Emerg Radiol, 17 (2010), pp. 473-477, 10.1007/s10140-010-0892-9
Updates to Study Attributes
Findings
was changed:
There is a displaced fracture (yellow arrow) of the 7th right costa at the site of pain pointed by the patient.
For comparison, asymptomatic 7th left costa was examined at second(second image which) and was intact.
Normal structures are depicted:
- Costochondral junction: white arrow
- Costal cartilage (rib cartilage segment): red arrow
- Rib
osseososseous segment: blue arrow
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