Subtle fracture at right 4th rib

Case contributed by Muhammad Shoyab
Diagnosis certain

Presentation

Fall from height (15 feet). Right femoral neck fracture. Bilateral pubic rami fractures.

Patient Data

Age: 25 years
Gender: Male

X-Ray Chest A/P (Supine) View

x-ray

Fracture with angulation at anterior end of right 4th rib, with mild displacement.

Case Discussion

While rib fractures are a common association of trauma, and may often be life-threatening, it is quite easy to miss them on plain x-ray. In the present case, the fracture could easily be missed if the other fractures (femoral, pubic rami) did not prompt meticulous search.

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