What is the role of radiography in the diagnosis of rib fractures?

Updated: Jun 13, 2017
  • Author: Sarah L Melendez, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Anteroposterior (AP) and lateral chest films are used routinely to assist in the diagnosis of rib fractures, yet sensitivity as low as 50% has been reported. Delayed or follow-up radiographs can be very helpful. Obtaining a rib radiograph series remains controversial, as the additional information rarely changes the clinical picture or alters treatment. Rib detail radiographs can be helpful in evaluation of the 1st and 2nd ribs and the 7th through 12th ribs. Chest CT scan (see the image below) is more sensitive than plain radiographs for detecting rib fractures. [7] Because first and second rib fractures are often associated with vascular injury, ED physicians should consider angiography for such patients, especially if symptoms and signs of neurovascular compromise are present. [5]


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