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Cough-induced rib fractures.

Viktor Hanak1, Thomas E Hartman, Jay H Ryu

  • 1Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.

Mayo Clinic Proceedings
|July 13, 2005
PubMed
Summary

Cough-induced rib fractures are common in women with chronic cough, often affecting middle ribs. Reduced bone density may be a factor, but fractures can occur even with normal bone density.

Area of Science:

  • Medical research
  • Pulmonology
  • Orthopedics

Background:

  • Cough-induced rib fractures are an under-recognized clinical entity.
  • Understanding their characteristics is crucial for diagnosis and management.

Purpose of the Study:

  • To define the demographic, clinical, and radiological features of patients experiencing cough-induced rib fractures.
  • To identify potential risk factors associated with these fractures.

Main Methods:

  • Retrospective, single-center study over a 9-year period.
  • Analysis of medical records for patients diagnosed with cough-induced rib fractures.
  • Evaluation of bone densitometry data (T scores) to assess bone density.

Main Results:

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  • 54 patients (78% female, mean age 55 years) presented with chest pain after coughing.
  • 85% had chronic cough (> or =3 weeks).
  • 112 rib fractures documented, most commonly affecting middle ribs laterally; 65% of patients with bone density testing had osteopenia or osteoporosis.

Conclusions:

  • Cough-induced rib fractures predominantly affect women with chronic cough.
  • Middle ribs, particularly along the lateral aspect, are most frequently fractured.
  • While reduced bone density is a likely risk factor, these fractures can occur in individuals with normal bone density.