Rib fractures (right 4th-6th)
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Right 4th-6th ribs are fractured anteriorly, mildly displaced. No pneumothorax or other abnormality.
Undisplaced or anterior rib fractures can be difficult to appreciate on normal PA projections.
Dedicated oblique views to detect rib fractures are not normally warranted because the treatment between traumatic chest pain with and without fractures does not differ markedly as treatment is symptomatic relief. However, PA projections should be obtained to assess for complications (e.g. pneumonia, pneumothorax, haemothorax) 1. Chest x-rays (even with optimised projections) may miss up to 50% of rib fractures 2.
- 1. DeLuca SA, Rhea JT, O'Malley TO. Radiographic evaluation of rib fractures. AJR Am J Roentgenol. 1982;138 (1): 91-2. doi:10.2214/ajr.138.1.91 - Pubmed citation
- 2. Bhavnagri SJ, Mohammed TL. When and how to image a suspected broken rib. Cleve Clin J Med. 2009;76 (5): 309-14. doi:10.3949/ccjm.76a.08026 - Pubmed citation