title: Rib fractures induced by coughing: an unusual cause of acute chest pain.
abstract: We report three patients with stress fractures of the ribs induced by coughing. Standard radiographs of the chest and ribs did not reveal evidence of rib fractures in any of the patients. Bone scintigraphy, performed 1 to 2 weeks after initial onset of symptoms, showed a focal area of increased uptake along the chest wall in all cases. Thin section angulated helical CT directly visualized the subtle rib fractures. Initial diagnosis of a cough-induced fracture of the rib may be difficult because of the associated underlying disorder, and unnecessary examinations are commonly performed. Identification of a cough-induced fracture of the rib using helical CT may be clinically important to avoid unnecessary concern and additional examinations.
authors.affiliation: Department of Emergency Radiology and Pneumology, University Hospital Vrije Universiteit Brussel, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: De Maeseneer
authors.forename: J
authors.initials: J
authors.lastname: De Mey
authors.forename: C
authors.initials: C
authors.lastname: Debaere
authors.forename: M
authors.initials: M
authors.lastname: Meysman
authors.forename: M
authors.initials: M
authors.lastname: Osteaux
mesh_terms: D000328:Adult; D000368:Aged; D001851:Bone Diseases, Metabolic / Q000150:complications; D002637:Chest Pain / Q000209:etiology; D003139:Common Cold / Q000150:complications; D003371:Cough / Q000150:complications*; D003937:Diagnosis, Differential; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D015775:Fractures, Stress / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012253:Rib Fractures / Q000000981:diagnostic imaging* / Q000209:etiology*; D014057:Tomography, X-Ray Computed / Q000379:methods*