Multimedia
 | Media file 1: Image of the common middle rib. The common middle rib consists of the neck that is closest to the thoracic spine with an articular tubercle—the angle of which is a curved portion of the rib—and the distal body. |
 | Media file 2: Image of central rib, viewed from the back, in which the subcostal groove is best seen. The costal artery and nerve follow the subcostal groove. |
 | Media file 3: Image of the first rib, which is one of the upper, specialized ribs. Important features of the first rib include the attachments of the scalenus medius and serratus anterior muscles. Grooves for the subclavian artery and vein represent important potential areas of serious injury in fractures of the first rib. |
 | Media file 4: Image of the 10th rib. Note that the 10th rib has a single articular facet. No direct anterior connection to the sternum is present. The forms of the 10th, 11th, and 12th ribs are similar. |
 | Media file 5: Image of a typical upper thoracic rib. Each of the 9 upper thoracic ribs has 2 posterior articulations with a thoracic vertebral body above and below (costovertebral junction [CVJ]) and an anterior articulation with the sternum (costochondral junction [CCJ]). VB = vertebral body. |
 | Media file 6: Image of the 12th rib. Note the single articular facet and the absence of an angle. |
 | Media file 7: Frontal image of the rib cage. Ribs 1-12 demonstrate the variable shape of the upper 9 ribs. The 12th rib does not articulate anteriorly. The sternum consists of the manubrium (M), the body (S), and the xiphoid (X). The ribs articulate with the sternum via the costochondral (CC) junction. C = clavicle. |
 | Media file 8: Posterior image of the thorax. The ribs are numbered 1-12. The clavicle (C) and scapula (S) are often involved in injuries that include rib fractures. |
 | Media file 9: Anteroposterior (AP) chest radiograph in a patient who presented with severe left chest wall pain after a minor fall. No rib injury is apparent. |
 | Media file 10: Anteroposterior (AP) radiograph of an elderly female patient with severe left chest wall pain after a minor fall. This image demonstrates a left lateral rib fracture (arrow) that is not seen on the standard AP chest radiograph. |
 | Media file 11: This detailed oblique radiograph shows 2 rib fractures (arrows) that are not depicted on anteroposterior (AP) chest radiographs (same patient as in Image above). |
 | Media file 12: This anteroposterior (AP) chest radiograph demonstrates a left lateral lower rib fracture (white arrow). In addition, there is an associated left subcutaneous gas pattern that dissects along the left chest wall (black arrow). |
 | Media file 13: Semi-erect anteroposterior (AP) chest radiograph in a patient with a nondisplaced posterior fracture of the left 10th rib. A small, apical pneumothorax (black arrow) is present on the left, and there is volume loss in the left lower lobe (white arrow). |
 | Media file 14: Image depicting multiple fractures of the left upper chest wall. The first rib is often fractured posteriorly (black arrows). If multiple rib fractures occur along the midlateral (red arrows) or anterior chest wall (blue arrows), a flail chest (dotted black lines) may result. |
 | Media file 15: Anteroposterior (AP) supine chest radiograph that was obtained upon a patient's arrival in the emergency department after a serious automobile accident. Although rib fractures are identified along the left lateral chest wall (black arrows), the transportation bed created superimposed metal artifacts (blue arrows) that obscure visualization of possible other rib fractures along the chest wall. |
 | Media file 16: Supine anteroposterior (AP) chest radiograph that was obtained after the removal of metal artifacts along the left chest wall (same patient as in Image 15). Multiple posterolateral rib fractures are noted on the left (arrows; Note: White and black arrows were used for easy visualization due to the dark and light areas of the lungs). |
 | Media file 17: Supine anteroposterior (AP) chest radiograph shows the presence of a right tension pneumothorax, which has displaced the trachea to the right (blue arrow). A displaced right lower rib fracture is present in the right posterolateral aspect of the chest (black arrow). |
 | Media file 18: Axial computed tomography image of the chest in a patient with multiple left posterior rib fractures. A large left pneumothorax is present (arrows). |
 | Media file 19: Axial computed tomography image of the chest in a patient with left posterior rib fractures. The left pneumothorax (white arrows) is associated with a displaced posterior left rib fracture (black arrow). Secondary effects on the left lung include a pulmonary contusion and volume loss. |
 | Media file 20: Axial computed tomography image of the chest in a patient with trauma to the left chest wall, where air (yellow arrow) is noted. A small left pneumothorax (blue arrow) is present, and the posterior left lung and the pleural space are opacified due to the combination of a left hemothorax and a left pulmonary contusion. |
 | Media file 21: Supine anteroposterior (AP) chest radiograph. This image demonstrates increased opacity of the left lateral upper lobe (arrow), a finding that is consistent with a pulmonary contusion after left chest wall trauma and rib fractures. |
 | Media file 22: Axial computed tomography image of the chest in a patient with a complex, unstable, thoracic spinal fracture. Multiple rib fractures (white arrows) are shown. In addition, the midthoracic spine is fractured (yellow arrow), and a large right hemothorax (HT) is present. CT = chest tube. |
 | Media file 23: Axial computed tomography image of the lower cervical spine in a patient with multiple rib fractures and an unstable fracture of the thoracic spine. Air has dissected into the epidural space posterior to the cervical dura (arrows). |
 | Media file 24: Sagittal reformatted computed tomography image of the cervical spine in a patient with multiple rib fractures and an unstable thoracic spinal injury (same patient as in Image above). Epidural gas is noted dorsally in the spinal canal (arrows). |
 | Media file 25: Abdominal radiograph. This image demonstrates moderate gaseous distention. The distended stomach was associated with a hemoperitoneum. |
 | Media file 26: Axial computed tomography image of the chest in a patient with both anterior and posterior thoracic injuries. A fracture of the sternum (white arrow) and a posterior left rib fracture (yellow arrow) are present. |
 | Media file 27: Axial computed tomography image of the lower thorax in a patient with multiple trauma. A left lower posterior rib fracture has resulted in a splenic contusion (arrow). |
 | Media file 28: Axial computed tomography image in a patient with a severe thoracic injury. Rib fractures and a complex left scapular fracture (arrows) are present. |
 | Media file 29: Axial computed tomography image of the chest. This image demonstrates a comminuted fracture of the body of the sternum (white arrows). The aorta was intact in this case. Note the bilateral posterior pulmonary contusions (yellow arrows). |
 | Media file 30: Axial computed tomography image of multiple left upper rib fractures and a traumatic aortic rupture. The contour of the aorta (A) is distorted (arrow) at the site of the aortic rupture. The rib fractures are also associated with a left hemothorax (H). |
 | Media file 31: Axial computed tomography image of the chest in a patient with multiple anterior and posterior rib fractures. A liver laceration is present. Air is noted in the subcutaneous space surrounding the left ribs (white arrows), blood is in the perisplenic space (black arrow), and a subcutaneous emphysema is present along the left chest wall. The patient was also treated for a large left pneumothorax. |
 | Media file 32: Axial computed tomography image of the brain in a patient with multiple rib fractures and a tension pneumothorax. Multiple bilateral cerebral infarcts are present (arrows). The direct injury to the brain was less complicated by hypoxia. |
 | Media file 33: Chest radiograph in a patient who presented with a gunshot wound to the anterior chest wall. Note the pulmonary contusion (arrow). The bullet struck an anterior right rib, resulting in a rib fracture. Other injuries involved the pleura and lung on the right. |
 | Media file 34: Axial computed tomography image of the chest in a patient with a gunshot wound. Note the comminuted rib fracture (black arrow). A lung contusion is present along the path of the bullet (yellow arrow). A chest tube was placed to treat the right pneumothorax. |
 | Media file 35: Computed tomography image of the chest. This image demonstrates bilateral lower lobe volume loss in a patient with multiple rib fractures. |
 | Media file 36: Right rib radiograph in a 48-year-old male who presented with severe right posterior chest wall pain following a fall. This image demonstrates 2 fractures of the right chest wall (white arrows). |
 | Media file 37: Computed tomography image of the chest in a patient who sustained multiple rib fractures. This image demonstrates an irregular area of low density in the medial posterior right lobe of the liver, a pattern that is consistent with a liver contusion. |
 | Media file 38: Computed tomography image of the chest. Posterior lateral rib fractures are noted (white arrow), as well as multiple liver contusions. |
 | Media file 39: Chest radiography in a patient who had sustained a fall 2 weeks previous to presentation. The patient complained of right-sided chest pain. |
 | Media file 40: Computed tomography image of the chest. This image demonstrates a posterior right chest wall rib fracture, which is related to a contusion within the right lobe of the liver. |
 | Media file 41: Axial computed tomography image of the chest. This image demonstrates a posterior fibro thorax (ie, fibrosis of the pleural space) (white arrows). |
More on Rib, Fractures |
| Overview: Rib, Fractures |
| Imaging: Rib, Fractures |
| Follow-up: Rib, Fractures |
 Multimedia: Rib, Fractures |
| References |
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Further Reading
Keywords
rib fractures, cracked ribs, broken ribs, chest wall trauma, chest-wall trauma, crushed chest injury, chest trauma, thoracic trauma, blunt chest trauma, flail chest, pneumothorax, hemothorax, hemopneumothorax
