No abstract available.
Immobilization* ; Rib Fractures* ; Ribs*

Humans ; Rib Fractures ; Thoracic Injuries

OBJECTIVES: This paper proposes a measurement method to quantify the abnormal characteristics of the broken parts of ribs using local texture and shape features in chest radiographs. METHODS: Our measurement method comprises two steps: a measurement area assignment and sampling step using a spline curve and sampling lines orthogonal to the spline curve, and a fracture-ness measurement step with three measures, asymmetry and gray-level co-occurrence matrix based measures (contrast and homogeneity). They were designed to quantify the regional shape and texture features of ribs along the centerline. The discriminating ability of our method was evaluated through region of interest (ROI) analysis and rib fracture classification test using support vector machine. RESULTS: The statistically significant difference was found between the measured values from fracture and normal ROIs; asymmetry (p < 0.0001), contrast (p < 0.001), and homogeneity (p = 0.022). The rib fracture classifier, trained with the measured values in ROI analysis, detected every rib fracture from chest radiographs used for ROI analysis, but it also classified some unbroken parts of ribs as abnormal parts (8 to 17 line sets; length of each line set, 2.998 +/- 2.652 mm; length of centerlines, 131.067 +/- 29.460 mm). CONCLUSIONS: Our measurement method, which includes a flexible measurement technique for the curved shape of ribs and the proposed shape and texture measures, could discriminate the suspicious regions of ribs for possible rib fractures in chest radiographs.
Decision Support Techniques ; Rib Fractures ; Ribs ; Thorax

OBJECTIVE: to determine the frequency of the multiple consecutive rib fracture after blunt chest trauma. DESIGN, MATERIALS, AND METHODS: We retrospectively reviewed all the radiographs and medical charts of 87 patients with rib fractures after blunt chest trauma. Rib fractures were divided into single aud multiple. The multiple rib fractures were subclassified as consecutive, interrupted continuous, or random. RESULTS: Thirteen cases of single and 83 cases of multiple rib fractures were present. Among the 83 cases of multiple fractures, there were 73 cases (88%) of consecutive fractures, 5 cases (6%) of interrupted continuous fractures and 5 cases (6%) of random fractures. CONCLUSION: Among the multiple rib fractures consecutive rib fractrues are much more common than noncontiguous rib fractures. We recommend that if one find an apparently nonfractured rib between contiguously fractured upper and lower ribs, one should meticulously search for possible fracture of an apparently normal rib with high-index of suspicion.
Humans ; Retrospective Studies ; Rib Fractures* ; Ribs* ; Thorax*

BACKGROUND: In trauma patients, bony thorax are exposured to the trauma in many cases. With simple x-ray, we can not detect all definitive bony abnormalities, especially in less severe cases. Bone scan is very sensitive diagnostic method in such cases. MATERIALS AND METHODS: We experienced 680 cases and results were as follows. RESULTS: 1. Diagnostic sensitivity was 97.4% and false negative rate was 2.6%. 2. In sensitivity study, the time factor (when we perform bone scan) was the most important thing according to trauma pattern. In rib fracture, sensitive test time was after 1 week. In sternal fracture, sensitive test time was after 1 week, too. In costochondral junction fracture and combined cases, it was after 3 days. CONCLUSIONS: We recommend timely using of bone scan as definitive diagnostic method in bony thorax trauma patients.
Humans ; Rib Fractures ; Thorax* ; Time Factors

Subclavian artery occlusion after blunt trauma is an extremely rare injury. This has been attributed to its wellprotected location deep in the scalene triangle, bounded by the first rib and clavicle. A case of post-traumatic occlusion of the subclavian artery with clavicle fracture was reported by Sodhi et al in 2006 and in Korea was reported by Han et al in 2001. We believe that is the first report of post-traumatic occlusion of the subclavian artery without clavicle and first rib fracture in Korea.
Clavicle ; Korea ; Rib Fractures ; Ribs ; Subclavian Artery ; Wounds, Nonpenetrating

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare the clinical results of kyphoplasty between osteoporotic patients with compression fractures and rib hot uptake on bone scan and patients without rib hot uptake. SUMMARY OF LITERATURE REVIEW: The incidence of osteoporotic rib fractures is 0.3% in postmenopausal women. MATERIALS AND METHODS: Between July 2005 and July 2006, 72 kyphoplasties for osteoporotic vertebral compression fractures were performed, and all patients had a bone scan study. On bone scan study, 41 patients (57.7%) had hot uptake in their ribs. Results were assessed by visual analog scale (VAS). RESULTS: The incidence of hot uptake was 67.8% in thoracic fractures, 40.0% in lumbar fractures, and 72.7% in thoracolumbar fractures. Hot uptake was significantly more common with thoracic and thoracolumbar fractures than with lumbar fractures (p<0.05). The incidence of hot uptake was 49.1% in one- and two-level fractures and 84.6% in over three-level fractures. This finding demonstrated significant difference between the two groups (p<0.05). The mean VAS scores for all cases were 8.2/3.4/3.2 at preoperative/immediate postoperative/after 3 months, respectively. In thoracic fractures, they were 8.2/3.9/3.1; lumbar fractures 8.0/3.2/3.1; and thoracolumbar fractures 8.3/3.7/3.0, respectively. The immediate postoperative VAS score in lumbar fractures was better than in thoracic fractures (p<0.05). The VAS scores in thoracic fractures with hot uptake were 8.3/4.1/3, and those without hot uptake were 7.8/2.8/3.0. The immediate VAS score in thoracic fractures without hot uptake was better than in those with hot uptake (p>0.05). CONCLUSIONS: Thoracic and multiple osteoporotic compression fractures are often accompanied by rib fractures. Bone scan is a useful tool to detect rib fractures and predict the prognosis of kyphoplasty.
Fractures, Compression ; Humans ; Incidence ; Kyphoplasty ; Prognosis ; Retrospective Studies ; Rib Fractures ; Ribs

PURPOSE: Rib fractures are the most common injuries resulting from blunt chest trauma. The sensitivity of conventional chest radiography (chest PA, rib series) in showing a rib fracture is limited, particularly in those involving the cartilage part of the rib. We investigated the possible rib fractures. We used ultrasonography (US) to investigate possible rib fractures in patients with minor blunt chest trauma who showed no evidence of a rib fracture on the conventional chest radiography. METHODS: A total of 96 patients with minor blunt chest trauma and showing no evidence of a rib fracture on the conventional chest radiography were examined with US performed with a 7.5-MHz linear transducer. RESULTS: A total of 44(45.8%) patients showed a rib fracture whereas 52(54.2%) patients had no evidence of a rib fracture. Fracture of the rib with displacement 24 patients was the most common finding. CONCLUSIONS: Rib US is a useful imaging method in showing rib fractures overlooked on chest X-rays in cases of minor blunt chest trauma. Compared with conventional chest radiography, rib US takes a shorter time and is not difficult. Additionally, lesions combined with rib fractures and costal cartilage fractures are diagnosed more easily when using rib US.
Cartilage ; Fractures, Cartilage ; Humans ; Radiography ; Rib Fractures* ; Ribs* ; Thoracic Injuries ; Thorax ; Transducers ; Ultrasonography*

Glucocorticoid (GC) excess, including Cushing's syndrome, is a common cause of secondary osteoporosis. Thirty to fifty percent of Cushing's syndrome patients experience non-traumatic fractures, which is often the presenting manifestation of Cushing's syndrome. However, there have been rare cases of Cushing's syndrome diagnosed only based upon bone manifestations. We describe a case of Cushing's syndrome that was diagnosed in a 44-year-old woman who initially visited our hospital due to multiple non-traumatic rib fractures. She did not exhibit any other manifestations of Cushing's syndrome such as moon face, buffalo hump or abdominal striae. Initially, we evaluated her for bone metastases from a cancer of unknown origin, but there was no evidence of metastatic cancer. Instead, we found a left adrenal incidentaloma. As a result of the hormone study, she was diagnosed as having Cushing's syndrome. Interestingly, her bony manifestation of Cushing's syndrome, which was evident in the bone scan and bone mineral densitometry, completely recovered after a left adrenalectomy. Therefore, the possibility of Cushing's syndrome as a cause of secondary osteoporosis should be considered in young patients with non-traumatic multiple fractures, with or without any other typical features of Cushing's syndrome.
Adrenalectomy ; Adult ; Buffaloes ; Cushing Syndrome* ; Densitometry ; Female ; Humans ; Neoplasm Metastasis ; Osteoporosis ; Rib Fractures*

PURPOSE: We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. MATERIALS AND METHODS: Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. RESULTS: Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. CONCLUSION: Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.
Cartilage ; Humans ; Incidence ; Radiography* ; Rib Fractures* ; Ribs* ; Thoracic Injuries* ; Thoracic Wall ; Thorax* ; Ultrasonography*