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Best X Ray View For Rib Fracture

author
James Lee
• Wednesday, 30 December, 2020
• 7 min read

A lot of people have been viewing and requesting this post recently. Here’s a neat trick for finding hard to see rib fractures on standard chest rays.

ribs broken ray rib fracture fractures trauma science library thoracic injuries
(Source: www.merckmanuals.com)

Contents

Although chest CT is the “gold standard” for finding every possible rib fracture present, it should never be used for this. Pain management and pulmonary toilet are the mainstays, and having an exact count doesn’t matter.

Would you deny these treatments in someone with focal chest wall pain and tenderness with no fractures seen on imaging studies? Here’s the trick. Our eyes follow arches (think McDonald’s) better than all these crazy lines and curves on the standard chest ray.

So tip the ray on its side and make those curves into nice arches, then let your eyes follow them naturally: Now you have to use the rotate buttons to properly position the digital image.

Final exam: click here to view a large digital image of a nearly normal chest ray. When a clinician suspects an isolated rib fracture, without additional injury, the protocol is often quite simple: treat the pain, not the break.

A lot of people have been viewing and requesting this post recently. Here’s a neat trick for finding hard to see rib fractures on standard chest rays.

ribs rib fractured chest fracture flail radiograph multiple fractures producing fig bones cage teachmeanatomy articulations
(Source: teachmeanatomy.info)

Although chest CT is the “gold standard” for finding every possible rib fracture present, it should never be used for this. Pain management and pulmonary toilet are the mainstays, and having an exact count doesn’t matter.

Would you deny these treatments in someone with focal chest wall pain and tenderness with no fractures seen on imaging studies? Here’s the trick. Our eyes follow arches (think McDonald’s) better than all these crazy lines and curves on the standard chest ray.

So tip the ray on its side and make those curves into nice arches, then let your eyes follow them naturally: Now you have to use the rotate buttons to properly position the digital image.

Severe thoracic injury often requires CT examination. Rib fractures are often found unexpectedly in patients with chest pain as they may occur without a clear history of trauma.

EtiologyPlain radiograph CT more sensitive than plain radiography for the detection of rib fractures 1,3 Displacement on CT may be defined as greater than half a rib shaft width 19 Ultrasound Common application of point of care ultrasonography, used in a complementary manner to conventional radiography in the workup of blunt chest wall trauma and localized chest pain.

lateral spine ray immagine laterale lumbar raggi dorsale spina faccia vista dell della vertebrae fracture compression
(Source: cartoondealer.com)

Rib fractures themselves are treated symptomatically and have a good prognostic outcome. Rarely, severe rib injuries (e.g. flail chest) may be treated with ORIN, often in the setting of other severe traumatic injuries and in the hope that respiratory function will improve facilitating a shorter ICU stay and quicker recovery.

Complications Aside from immediate traumatic complications outlined above atelectasis and pneumonia may develop, mainly due to poor respiratory effort secondary to pain, and this increases the morbidity and mortality due to rib fractures 3. Kali R, Avery LL, Assani AV et-al. Multi detector CT of blunt thoracic trauma.

Oikonomou A, Prassopoulos P. CT imaging of blunt chest trauma. Kottachchi DT, Dong J, Reid S. A rare complication of cardiopulmonary resuscitation.

Hurley ME, Eye GD, Hamilton S. Is ultrasound really helpful in the detection of rib fractures?. Asia K, Shipyard Y, Nakamura K et-al. Radiation-induced rib fractures after hypofractionated stereotactic body radiation therapy: risk factors and dose-volume relationship.

Radiation-induced rib fractures after hypofractionated stereotactic body radiation therapy of non-small cell lung cancer: a dose- and volume-response analysis. Yousefifard M, Balfour M, Ghelichkhani P, Away H, Warfarin A, Mini Isfahan MR, Hosseini M, Laser M, Safari S. Comparison of Ultrasonography and Radiography in Detection of Thoracic Bone Fractures; a Systematic Review and Meta-Analysis.

fracture rib comminuted chest ray showing figure
(Source: www.jpgmonline.com)

Pushkin E, Ahmadi K, Forward M, Sale hi M, Saladin Those F, Rahimi-Movaghar V. Comparison of ultrasonography and radiography in diagnosis of rib fractures. (2017) Chinese journal of traumatology = Songhua Chang Shang ZA hi.

Somali M, True H, Top S, Julian E, Yazidi U, Kaya S, Taste I. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management.

Griffith OF, Trainer TH, Ching AS, Law KL, Cocks RA, Metreweli C. Sonography compared with radiography in revealing acute rib fracture. Turk F, Kurt AB, Sag lam S. Evaluation by ultrasound of traumatic rib fractures missed by radiography.

Disclosure of unnoticed rib fractures with the use of ultrasonography in minor blunt chest trauma. Martin VT, Zen L, Dengue JC, Mao L, Huang J, Peng X.

The use of a portable ultrasound system in the surgical assessment of rib fractures in an elderly patient. Trainer TH, Griffith OF, Lam E, Lam PK, Metreweli C. Comparison of thoracic ultrasound, clinical acumen, and radiography in patients with minor chest injury.

fracture ultrasound rib fractures bone skull minor diagnose example
(Source: www.emhum.com)

The number of displaced rib fractures is more predictive for complications in chest trauma patients. (2017) Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

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Sources
1 thisibelieve.org - https://thisibelieve.org/essay/60592/
2 simple.wikipedia.org - https://simple.wikipedia.org/wiki/The_Wheel_of_Fortune
3 thinkexist.com - http://thinkexist.com/quotation/life-s-a-wheel-of-fortune-and-it-s-my-chance-to/411613.html
4 www.free-tarot-reading.net - https://www.free-tarot-reading.net/card-meanings/major_arcana/wheel-of-fortune/Lynn
5 www.edelwyn.com - https://www.edelwyn.com/wheel-of-fortune/