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Flail Chest-I

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...

Flail Chest-II

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:

The Thoracic Cage: Ribs

The Thoracic Cage: Ribs

Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...

Fractures: Bone Repair

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

Pneumothorax-I

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.

Pneumothorax-II

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:

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Updated: Sep 15, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Published on: September 13, 2020

Atraumatic first rib fracture after weightlifting.

Kelley Gorsuch¹, Sean M Bryant¹

¹Cook County Health, Department of Emergency Medicine, Chicago, IL, United States of America.

The American Journal of Emergency Medicine

|July 16, 2025

Summary

Atraumatic first rib fractures are rare emergency department diagnoses. Consider this injury in patients with shoulder pain after weightlifting, as CT scans can reveal fractures missed on X-rays.

Keywords:

Fracture Rib Weightlifting

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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Area of Science:

Emergency Medicine
Orthopedic Surgery
Radiology

Background:

Atraumatic first rib fractures are infrequently diagnosed in emergency settings.
Case reports detailing this specific injury are scarce within emergency medicine literature.
This highlights a potential gap in recognizing uncommon fractures.

Observation:

A 26-year-old male presented with severe right shoulder pain following a weightlifting session.
Initial plain radiographs of the shoulder did not reveal any fracture or dislocation.
A subsequent computed tomography (CT) scan definitively identified a fracture of the first rib.

Findings:

The study identified an atraumatic first rib fracture in a young adult male.
The fracture was not apparent on initial plain radiography, necessitating advanced imaging.
Computed tomography proved crucial for diagnosing this uncommon injury.

Implications:

Emergency physicians should consider first rib fractures in the differential diagnosis for shoulder pain after strenuous or explosive activities like weightlifting.
The findings underscore the importance of advanced imaging modalities when initial radiographs are inconclusive for suspected fractures.
Increased awareness and reporting of such cases can improve diagnostic accuracy and patient management in emergency medicine.