title: Cough-induced rib fractures.
abstract: BACKGROUND
  Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures.
  
  
  METHODS
  Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively.
  
  
  RESULTS
  Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently.
  
  
  CONCLUSIONS
  Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis.
authors.affiliation: Department of Thoracic Surgery, Chigasaki Municipal Hospital, Chigasaki, Japan sanoa-tky@umin.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sano
authors.affiliation: Department of Respiratory Medicine, Chigasaki Municipal Hospital, Chigasaki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tashiro
authors.affiliation: Department of Respiratory Medicine, Chigasaki Municipal Hospital, Chigasaki, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Fukuda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology*; D003371:Cough / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012253:Rib Fractures / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Chest pain; Cough; Radiography; Rib fractures; Thoracic wall; thoracic