Rib Fractures
Pathology: A condition in which one of the bones comprising of the rib cage fractures, the fracture can be complete or incomplete (Dutton, 2008). Complete rib fractures are more serious as there is a potential of puncturing the internal organs.
Demographics: (Mahoney & Doty, 2010) Rib fractures are most commonly associated with motor vehicle accidents, at nearly 2 million a year. Rib fractures can also occur as a result of high force repetitive movements in athletes, osteoporosis, cancer metastasis to the bone or violent coughing in previously weakened bones (Holcomb et al, 2003).
Clinical Presentation: (Mahoney & Doty, 2010; Dutton, 2008) Sharp, localized pain at the site of fracture that sharply increases with breathing and trunk motions (inspiration, laughing, sneezing and coughing). The patient may also present with swelling and bruising over the fracture site.
Differential Diagnosis: (Goodman & Snyder, 2007; Mahoney & Doty, 2010)A thorough patient history to determine the extent of the injury, including history of cancer to assess for possible metastasis, osteoporosis, long-term steroid use, reviewing all red flag and constitutional signs and symptoms to check for systemic illness. Examination should also include assessing the site through palpation checking for signs of crepitus and deformity. Chest wall excursion can also be assessed and a tap test can be performed to detect a fracture. Pulmonary and cardiac conditions should be ruled out during the examination.
Clinical Bottom Line: This condition is a call for referral if not yet diagnosed. Radiographs can be used to determine if there is a fracture. Other tests include a urine analysis to detect hemanaturia, ultrasound, CT scan and angiogram to detect vascular involvement (Mahoney & Doty, 2010). In most cases the bone is given time to heal with limited movement, instruction is given on appropriate respiratory care to prevent pneumothorax and pneumonia.
Demographics: (Mahoney & Doty, 2010) Rib fractures are most commonly associated with motor vehicle accidents, at nearly 2 million a year. Rib fractures can also occur as a result of high force repetitive movements in athletes, osteoporosis, cancer metastasis to the bone or violent coughing in previously weakened bones (Holcomb et al, 2003).
Clinical Presentation: (Mahoney & Doty, 2010; Dutton, 2008) Sharp, localized pain at the site of fracture that sharply increases with breathing and trunk motions (inspiration, laughing, sneezing and coughing). The patient may also present with swelling and bruising over the fracture site.
Differential Diagnosis: (Goodman & Snyder, 2007; Mahoney & Doty, 2010)A thorough patient history to determine the extent of the injury, including history of cancer to assess for possible metastasis, osteoporosis, long-term steroid use, reviewing all red flag and constitutional signs and symptoms to check for systemic illness. Examination should also include assessing the site through palpation checking for signs of crepitus and deformity. Chest wall excursion can also be assessed and a tap test can be performed to detect a fracture. Pulmonary and cardiac conditions should be ruled out during the examination.
Clinical Bottom Line: This condition is a call for referral if not yet diagnosed. Radiographs can be used to determine if there is a fracture. Other tests include a urine analysis to detect hemanaturia, ultrasound, CT scan and angiogram to detect vascular involvement (Mahoney & Doty, 2010). In most cases the bone is given time to heal with limited movement, instruction is given on appropriate respiratory care to prevent pneumothorax and pneumonia.