Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Breathing Difficulty Post Rib Injury Despite A Normal X-ray?
Posted on
Sat, 20 Aug 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Sat, 20 Aug 2016
Answered on
Sat, 10 Sep 2016
Last reviewed on
Question : my husband was hit in the chest by a large tree that snapped when he was cutting it. It hit him extremely hard, sent him flying and knocked the wind out of him. Took him to ER they only took 2 xrays from the side and said no broken ribs. That was 4 days ago. he is still having some trouble breathing like he has constant heartburn. If he coughs the pain floors him for nearly an hour. There is sharp stabbing very bad pain middle of chest around upper sternum area, slightly to the right. He can barely get up from lying down and cant use his arms much or lift anything. His chest looks a little sunken in the middle.
Brief Answer:
Needs proper clinical evaluation and CT scan of chest and chest wall
Detailed Answer:
Hi.
Thanks for your query about your husband.
To recapitulate: Male/58 - hard hit in the chest by a large tree - 4 days ago - sent him flying - ER- 2 X-rays - said no broken ribs - trouble breathing like constant heartburn - coughing floors him - sharp stabbing pain to the right of upper sternum - barely can get up - can't use his arm or lift anything - chest looks like sunken in ...
The history if suggestive of the following:
Severe costo-sternal junction inflammation due to transmitted force of hit.
Fractured rib/s, can be missed on X-rays.
Severe myalgia of the muscles on the affected side.
I would advise you the following:
- Insist on CT scan of the chest and chest wall with a marker put on the point/area of maximum pain/tenderness. This will help to have a proper diagnosis and also rule out an internal injury.
- Second opinion of a General Surgeon for clinical evaluation, examination and investigations.
- Stick-on type of Corset on the affected side to stabilize the traumatized tissues or a corset whatever suits you.
- Continue Ibuprofen
I hope this answer helps to get a proper diagnosis and a plan of curative treatment.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Needs proper clinical evaluation and CT scan of chest and chest wall
Detailed Answer:
Hi.
Thanks for your query about your husband.
To recapitulate: Male/58 - hard hit in the chest by a large tree - 4 days ago - sent him flying - ER- 2 X-rays - said no broken ribs - trouble breathing like constant heartburn - coughing floors him - sharp stabbing pain to the right of upper sternum - barely can get up - can't use his arm or lift anything - chest looks like sunken in ...
The history if suggestive of the following:
Severe costo-sternal junction inflammation due to transmitted force of hit.
Fractured rib/s, can be missed on X-rays.
Severe myalgia of the muscles on the affected side.
I would advise you the following:
- Insist on CT scan of the chest and chest wall with a marker put on the point/area of maximum pain/tenderness. This will help to have a proper diagnosis and also rule out an internal injury.
- Second opinion of a General Surgeon for clinical evaluation, examination and investigations.
- Stick-on type of Corset on the affected side to stabilize the traumatized tissues or a corset whatever suits you.
- Continue Ibuprofen
I hope this answer helps to get a proper diagnosis and a plan of curative treatment.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
