title: Spontaneous rib fractures.
abstract: BACKGROUND
  Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications.
  
  
  METHODS
  Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs.
  
  
  RESULTS
  The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year.
  
  
  CONCLUSIONS
  Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions.
authors.affiliation: Department of Thoracic Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Katrancioglu
authors.affiliation: Department of Thoracic Surgery, Ankara Numune Research and Training Hospital, Ankara, Turkey y.akkas@yahoo.com.
authors.forename: Yucel
authors.initials: Y
authors.lastname: Akkas
authors.affiliation: Department of Chest Diseases, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Sulhattin
authors.initials: S
authors.lastname: Arslan
authors.affiliation: Department of Thoracic Surgery, Cumhuriyet University School of Medicine, Sivas, Turkey.
authors.forename: Ekber
authors.initials: E
authors.lastname: Sahin
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications* / Q000188:drug therapy; D015519:Bone Density; D003371:Cough / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies; D012253:Rib Fractures / Q000209:etiology*
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Asthma; Chest pain; Cough; Osteoporosis; Pulmonary disease; Rib fractures; chronic obstructive