Broken Rib On X-ray And CT Scan

Broken ribs are common after trauma to the chest wall.  Broken ribs are painful and can cause damage to internal organs at times.  X-rays and CT are frequently used to diagnose rib fractures.  Rib fractures can not always be seen on X-ray.  A CT scan of the chest is the best test and gives the most detail of the ribs.

What is a rib fracture?

There are 12 ribs on both sides of the chest.  They function to protect the vital organs in the chest and upper abdomen.  The ribs can break after trauma.  This is called a rib fracture in medical terms.

What does a broken rib feel like?

There will be pain which is most severe with breathing.  A rib can cause a pneumothorax or collapsed lung resulting in difficulty breathing.

There can be damage to internal organs like the kidneys, liver and spleen.

Difficulty breathing from broken ribs can lead to pneumonia which can cause fever and breathlessness.

How is a rib fracture diagnosed?

Broken ribs are diagnosed on X-rays and CT scan.

Broken rib on X-ray

Rib fractures are frequently evaluated with X-rays. Chest X-rays are often ordered but a rib X-ray series is best for diagnosing a fracture.  Rib X-rays include X-rays of the ribs taken from different angles.  Sometimes we can see a rib fracture on only one of the X-rays.

X-rays can miss rib fractures, especially those which are not separated. A CT scan is better to look for rib fractures.

A broken rib on X-ray will appear as a break in the bone along the rib.  The break can retain the normal alignment of the bone or cause the fragments to be separated.

Broken rib on CT

CT of the chest provides the most detail and best visualization of the ribs.  There are still times when a hairline fracture of a rib may not be seen.  Often we can see the ribs healing at a later time in these cases.

What is a displaced rib fracture?

This means the bones have shifted apart where the break in the rib occurred.  A non displaced fracture is one where there is a break but the bones are aligned as usual.

What else can look like a broken rib in radiology?

Usually broken ribs are straightforward to diagnose.  A healing fracture can sometime be confused with a bone lesion of the rib.  This becomes important if the patient has cancer and we are concerned about metastasis.

What causes a broken rib?

Most commonly we see rib fractures after injuries like falls.  Other examples are sporting accidents and motor vehicle crashes.

Some rib fractures are caused by severe coughing, bone weakening, and cancer which has spread to the bones.

Are rib fractures dangerous?

They can be at times.  This is because there can be injuries to the lung or abdominal organs which can be life threatening.

What are the complications of rib fractures?

By themselves rib fractures are rarely of consequence other then the pain they cause. They can however cause complications. The most significant is a pneumothorax or collapsed lung.  Pneumothorax will often be diagnosed on the X-rays ordered for diagnosing the rib fracture.

Other complications include injury to major blood vessels in the chest for fractures of the upper ribs.

Injury of the abdominal organs when the rib fractures are low. This would include injuries to the liver, spleen and kidney.

Injury to the lung can include a tear, bruising or herniation of the lung.

Pneumonia can develop from shallow breathing as a result of the pain from the rib fractures.

Rib fracture treatment.  What kind of doctor treats rib fractures?

Both primary care and specialty physicians can diagnose and treat rib fractures.  Broken ribs are commonly diagnosed in the emergency room and are treated by emergency room doctors.

Rib fractures without internal injuries can be treated with pain medicines, icing and breathing exercises to prevent pneumonia.

Surgery is rare and is usually indicated for internal injuries to organs.  The most serious rib fractures can be treated surgically to help with healing.

Rib fracture: summary

Rib fractures are most common after trauma.  They are frequently diagnosed on X-ray or CT.  They usually pose no danger to the patient but can rarely cause damage to internal organs.  Treatment for non complicated rib fractures includes supportive measures like pain medications and breathing exercises.