Science In Brief

Chiropractic Litterature Review

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The Study: Sonography of occult rib and costal cartilage fractures: a case series.

The Facts:

  1. The authors were looking at using diagnostic ultrasound to detect costal cartilage fractures and occult rib fractures.
  2. The study only covered three cases.
  3. The first patient had suffered a trauma to the chest. Ultrasound revealed fractured ribs but radiographs were interpreted as negative.
  4. The second patient had been diagnosed with a lower left rib fracture two months prior.. That diagnosis had been made clinically and no diagnostic imaging was done at the time. The pain persisted and when the patient was examined again ultrasound now revealed a costal fracture, however, radiography was negative at the time of re-examination.
  5. The third case had suffered trauma to the chest. Radiography one week after the trauma was negative. However, pain persisted and three weeks after the radiography an ultrasonic examination was done and revealed cortical discontinuity and callus formation on the second rib. A second ultrasound three weeks later "showed bridging of the callus indicating fracture healing."
  6. In these cases ultrasound "...was more sensitive for detecting acute, isolated fractures of the rib and costal cartilage than conventional radiography."

Take Home:

There are times that ultrasound will show fractures that are not apparent on the radiograph.

Reviewer's Comments:

This is quite interesting. If the patient has suffered from some injury where a costal or rib fracture might be suspected it appears that diagnostic ultrasound may reveal injuries not apparent on a radiograph. Another tool to aid in making the correct decisions regarding care.

Reviewer: Roger Coleman DC

Editor: Mark R. Payne DC

Reference: Matox R, Reckelhoff KE, Welk AB, Kettner NW. Sonography of occult rib and costal cartilage fractures: a case series. J Chiropr Med 2014;13:139-43

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/25685124 

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