CASE 546 Published on 24.10.2000

Z-shaped rib fractures

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

26 years, female

Categories

No Area of Interest ; Imaging Technique CT

No Procedure ; No Special Focus ;

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Clinical History

Car accident with a seatbelt syndrome

Imaging Findings

Belted 26-year-old female car passenger involved in a traffic accident

Discussion

Rib fractures are the most common injuries in blunt chest trauma. They are present in up to 81% of blunt chest trauma patients. The are encountered especially in motor vehicle crashes. In blunt trauma patients, rib fractures are multiple in 84% of cases and unique in the remaining 16%. Rib fractures most often hit the same site on several adjacent ribs or rib cartilages, thus resulting in a focal alignement called bridging rib fractures. Sixty percent of rib fractures, whatever their location, are overlooked by admission chest roentgenograms. Digitized radiology,through window setting modifications and reconstruction algorithms, is more sensitive.

Differential Diagnosis List

Blunt traumatic Z-shaped rib fractures

Final Diagnosis

Blunt traumatic Z-shaped rib fractures

References

[1] Harris AE, Toney MA.
Bridging rib fractures. Scintigraphic and radiographic findings.
Clin Nucl Med. 1993 Oct;18(10):915. (PMID: 8242994)

[2] Mayberry JC, Trunkey DD.
The fractured rib in chest wall trauma.
Chest Surg Clin N Am. 1997 May;7(2):239-61. (PMID: 9156291)

[3] Wintermark M, Schnyder P
Trauma of the chest wall. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 9-27 (2000).

[4] Ziegler DW, Agarwal NN.
The morbidity and mortality of rib fractures.
J Trauma. 1994 Dec;37(6):975-9. (PMID: 7996614)

Case information

URL:	https://eurorad.org/case/546
DOI:	10.1594/EURORAD/CASE.546
ISSN:	1563-4086

Figure 1

Blunt traumatic Z-shaped rib fractures

$Blunt traumatic Z-shaped rib fractures$

Admission chest X-ray displays a right clavicle fracture, as well as a right pneumothorax, persisting despite drainage, but does not depict any rib fracture (From Wintermark M, Schnyder P (2000) Trauma of the chest wall. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 9-27)

$Blunt traumatic Z-shaped rib fractures$