Cracked rib?

[Wahine]

This does not sound like a cracked rib. A cracked rib would be very pain sensitive right at the time of injury, it wouldn't be OK then get worse over the next few days. This sounds like a subluxed (partially dislocated on a small scale) rib. This diagnosis would account for the pain you're describing as well as the small lump under the breast. I would go have it x-rayed to confirm that it's not fractured (just in case) then if not fractured go see a manual physical therapist. You have some great one's in Norway. They should be able to relocate the rib, if that is what's wrong and get you back on the right track to healing.

Hope that helps.

[lph]

Thank you everybody! Especially you Wahine. I'll get my act together and go get it x-rayed.

Dang, this is a great forum

[SouthernBelle]

agree it doesn't sound cracked. That hurts then, not later. Well it hurts later. It hurts both!

[ChickWithBrains]

I disagree- you certainly could have broken a rib!

Most rib fractures are non-displaced; they sit in the same place the bones did before the break. And most rib fractures do not show up on xrays; they show up best several weeks after the injury when the bone remodeling and healing shows up as a faint white "ghost" on an xray.

When I see patients who have the kind of symptoms you have after an injury to the chest wall, my explanation after a good physical exam is always some variant of this:

You may or may not have broken one or more ribs. We will do x-rays, but even if you do have a fracture it's likely we will not be able to see it. However, the xrays WILL tell us if the act of breaking caused any damage to your lungs which we need to do something about.

If the xrays don't show any complications, we'll treat you the same whether we see the fracture or not. Medications to control your pain, teaching you how to splint the area when you cough, and a regimen of deep breathing to keep your airways expanded and help prevent infection in the lung underlying where it hurts you. Pain leads to shallow breathing, which can lead to very small areas of your lung collapsing, which is a risk factor for infection.

For people I'm really concerned about (the elderly or poorly mobile), I prescribe a handy little device you see at the bedside of people who had surgery: an incentive spirometer. 10 times an hour, you suck on the tube of this device and a little ball goes up in a chamber. Your goal is to get the ball to hit the top of the chamber. It's like hitting the plate with the hammer at the carnival: the higher up the ball goes, the better you're doing!

Just wanted to prepare you for the same treatment whether or not you've got an (uncomplicated) rib fracture. The diagnosis is clinical, not radiologic, and dislocation is far rarer than an occult fracture on xray.

[r900]

Hi lph, I hope you have been checked out for your pain. I think this may take you a few months to get over this. I dumped my mtn bike a few years back, crashed hard on my side. The impact was painful but afterward I rode back to my vehicle and called it a day. I was sort of numb on the side of my chest and when I went to bed , I could feel a 'click-clack' sound from my sternum. I did not go to a doctor but I wish I did. Three days after my crash I felt my left lung inflate when I walked up a hill outside my home. Other than that I felt great from my experience. Sneezing made me feel like my heart could pop out of my chest. Don't be as foolish as I was. Take care and rest easy.

[Xrayted]

I actually agree with Wahine and CWB. You can have cracked or subluxed (and yes, even broken ribs) and not feel it right away. I xray pts all the time that didn't feel it until a day or two later. Sometimes it's obvious and sometimes it's hard to detect what's up. We do chest xrays along with the rib series to look at the soft tissue to make sure something isn't punctured or avulsed in the area. As for the cracks, we advise a followup set of xrays in two weeks if the original ones are inconclusive. If they were cracked, they will show a healing callous most of the time.

I'd advise some xrays just to make sure. Think of it as getting a bonus look at your heart, lungs, esophagus, mediastinum, etc in the process. I do hope everything is ok and it's just a bruising. Take care and good luck.

[lph]

Hee-hee - this extra spate of posts is just what I needed now. I went climbing again yesterday, and the pain has almost gone away, to the point where I can just feel a slight soreness to the touch and when I breathe very deeply, but it doesn't hurt. So of course... I was going to skip the x-rays...

I promise, I'll order some x-rays today. If nothing else, I'd like to know what happened.

CwB - I think I taught myself to splint the area - found out pretty fast that supporting my ribs with one hand if possible before coughing or laughing helped. Is that what you meant?

Thank you everybody for great ideas!

[silver]

For people I'm really concerned about (the elderly or poorly mobile), I prescribe a handy little device you see at the bedside of people who had surgery: an incentive spirometer. 10 times an hour, you suck on the tube of this device and a little ball goes up in a chamber. Your goal is to get the ball to hit the top of the chamber. It's like hitting the plate with the hammer at the carnival: the higher up the ball goes, the better you're doing!
.

After my broken ribs and pneumothorax (sp?) this was the device from He!! I'd cry when the therapist would come into my room.

but like you said it was important to do.