This Is A Picture Of My Rib Injury From May

Posted on Sat, 1 Feb 2020

Question: this is a picture of my rib injury from may of last year, no bruising or discoloration. i took it right after it happened. one of my former roommates, who is around 250 lbs, fell on top of me. it looks exactly the same today, 6 months later, and doesn't feel like it has healed. the er doctor told me it was bruised and would heal after a few weeks. if you press on it, you feel bone. the area is still tender and throbs, sometimes crunchy feeling too.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

this is a picture of my rib injury from may of last year, no bruising or discoloration. i took it right after it happened. one of my former roommates, who is around 250 lbs, fell on top of me. it looks exactly the same today, 6 months later, and doesn't feel like it has healed. the er doctor told me it was bruised and would heal after a few weeks. if you press on it, you feel bone. the area is still tender and throbs, sometimes crunchy feeling too.

Answered by Dr. Bhagyesh V. Patel (48 minutes later)

Brief Answer:
inflammation of rib or intercostal ligament likely.

Detailed Answer:
Hello and welcome to Ask A Doctor services.
I have read your query with attached photo image and here is my advise.

* As per my surgical experience, there sounds underlying inflammation of
the rib or intercostal ligament responsible for pain, crunching feeling and
tenderness.

Kindly provide me further details so that I can answer your query completely.

1. Was any x-ray taken at the onset period ? If yes, report available ?
2. Any difficulty in breathing or routine works ?
3. Does cough raise the pain level ?
4. Current pain requires intake of analgesic medications or not ?

Awaiting for your response.
Thank you.
Regards.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (2 hours later)

the bone that is sticking out is jagged, and it feels like it is 90 degrees out of place. when i press down on it from above, it lays flat and feels normal. i have copies of the xrays but none are from the side, which would show the projecting bone. i feel like if it had been wrapped down initially, it would have healed/fused normally...

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Follow up: Dr. Bhagyesh V. Patel (2 minutes later)

off and on throbbing, range of motion loss, discomfort when breathing deeply, etc.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

off and on throbbing, range of motion loss, discomfort when breathing deeply, etc.

Answered by Dr. Bhagyesh V. Patel (7 hours later)

Brief Answer:
MRI needed.

Detailed Answer:
Hi
Thanks for the relevant details.

* Though the x-rays are not showing projecting bones, it is mostly possible a
ligament thickening post injury which will not show up on x-ray.

In my surgical opinion, you must discuss need of an MRI of the chest for more relevant detailed evaluation of soft tissue apart from bones.
There is definite reason of your throbbing and must be sorted out to cure in best possible manner.

Wish you best recovery.
Regards.

Dr Bhagyesh ( MS consultant surgeon )

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (54 minutes later)

Can i fix/heal this without surgery? Rib brace? it feels like the broken piece of a cracked 2Ã4 "Fracture of the Costal Cartilage: Presentation, Diagnosis, and Management A 52-year-old woman sustained a fracture of the left 7th costal cartilage after a ski injury. She presented complaining of painful clicking over the area. Initial imaging studies were negative for fracture; however, 3-dimensional reconstruction of a chestÂ computed tomography scan, formatted to costal cartilage, revealed the fracture. She was offered and underwent surgical fixation of the fracture with a plate and 4 screws using a biaxial, convergent construct. Postoperatively, her symptoms resolved. In this case report, we review the rationale for fixation of costal cartilage, including a summary of previous literature pertaining to this relatively rareÂ thoracic injury." https://www.sciencedirect.com/science/article/pii/S0000

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
follow up.

Detailed Answer:
Hi
I have gone through your case review literature.

* Individual needs of surgical or non surgical intervention is best decided by
the treating physician or surgeon as per his or her expertise.

However, if your reports are available, I can guide further in details.
Thank you.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (22 hours later)

in the part sticking out, the tip of my finger fits into a v-shaped groove...it's been six months since my injury date, when the emergency room doctor said it was a bruised rib, do you think it has healed too much that a rib brace would be hopeless? does this type of injury require a particular medical specialist?

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
orthopedic or sports medicine person is best to handle.

Detailed Answer:
Hi XXXXXXX
I have seen your additional attachments.

* As per my surgical experience, I recommend rib brace once the diagnosis
is confirmed for particular case.

Brace therapy works best if initiated within 10-15 days of tissue injury and there is scope for interference at tissue alignment levels possibly.

It may or may not be helpful in your case, and I would recommend proper diagnosis before using that as a trial therapy at a period of 6 months.

Orthopedic or sports medicine specialist is best person to handle such case very precisely.
Have a great day.
Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Bhagyesh V. Patel (8 hours later)

just did some research, and this is a common football and rugby injury that takes months, not weeks, to heal. since my injury site never showed visible exterior bruising/discoloration, does that mean i had/have nonvisible interior bruising/damage?

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (4 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Hi

Not necessarily external insult is needed for every internal pathology, as in your case.

There is definite reason of your concern and agony and the MRI or CT scan is the final answer for the same.
Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Bhagyesh V. Patel (2 hours later)

are emergency room doctors incompetent in diagnosing this type of injury? i mean, if i had gone to a different emergency room, would another doctor have made the same bruised-rib diagnosis, even without visible bruising? lol, it feels like i saw a doctor who graduated at the bottom of his class.

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (1 hour later)

Brief Answer:
no.

Detailed Answer:
Hi
No its not so that emergency room doctors are incompetent in diagnosing this type of injury, but many of the clinical issues require sequential follow up of the patient to arrive at a particular diagnosis.

Regards.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Bhagyesh V. Patel (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Bhagyesh V. Patel (40 minutes later)

ok, but the emergency room doctor never looked at or touched the injury site -- his diagnosis was based soley on xrays. i went to the er via ambulance, and after the er doctor reviewed the xrays in a different room, he then visited me and said i was free to go and would be fine after a few weeks of healing. could have just posted the picture here to get the same result, no?

Follow up: Dr. Bhagyesh V. Patel (0 minute later)

Answered by Dr. Bhagyesh V. Patel (3 minutes later)

Brief Answer:
follow up.

Detailed Answer:
Sorry to say , but the reports are only supportive and has to be co related with clinical findings and opinion.

Any clinical judgment is absolutely incomplete without examination of the patient, just on basis of reports.
This should not have been the case with an ER for sure.

Regards.

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Bhagyesh V. Patel (0 minute later)

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Above answer was peer-reviewed by : Dr. Prasad