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Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and ...


Feb 10, 2017 ... Traumatic rib injury is a common finding after blunt or penetrating thoracic ... However, the US examination may cause discomfort in some ... complications of rib injury, such as chest wall hematoma and pleural ... Axial CT image shows a thickened cortex (arrowhead) and disorganized and thickened matrix ... HomeRadioGraphicsVol. 37, No. 2 Trauma/Emergency RadiologyFree Access Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment Brett S. Talbot , Christopher P. Gange, Jr, Apeksha Chaturvedi, Nina Klionsky, Susan K. Hobbs, Abhishek Chaturvedi The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures. Specific attention is also required for flail chest and for fractures due to pediatric nonaccidental trauma. Rib fractures are associated with significant morbidity and mortality, both of which increase as the number of fractured ribs increases. Key complications associated with rib fracture include pain, hemothorax, pneumothorax, extrapleural hematoma, pulmonary contusion, pulmonary laceration, acute vascular injury, and abdominal solid-organ injury. Congenital anomalies, including supernumerary or accessory ribs, vestigial anterior ribs, bifid ribs, and synostoses, are common and should not be confused with traumatic pathologic conditions. Nontraumatic mimics of traumatic rib injury, with or without fracture, include metastatic disease, primary osseous neoplasms (osteosarcoma, chondrosarcoma, Ewing sarcoma, Langerhans cell histiocytosis, and osteochondroma), fibrous dysplasia, and Paget disease. Principles of management include supportive and procedural methods of alleviating pain, treating complications, and stabilizing posttraumatic deformity. By recognizing and accurately reporting the imaging findings, the radiologist will add value to the care of patients with thoracic trauma.

Pleura Thickening - an overview | ScienceDirect Topics


Diffuse pleural thickening (fibrothorax) can be secondary to empyema or hemothorax, tuberculous pleurisy, asbestos exposure, collagen vascular disease , and ... ! There was a problem providing the content you requested Please contact us via our support center for more information and provide the details below. Reference Number: 5783def63ffac781 Timestamp: 2020-03-23 00:00:14 UTC About ScienceDirect Shopping cart Contact and supportTerms and conditionsPrivacy policy

Successful Treatment of a Recalcitrant Pleural Effusion with Rib ...


Nov 9, 2012 ... Pulmonary complications of rib fractures typically occur in the immediate postinjury period, as a result of the forces causing the injury or ... US National Library of Medicine Search databaseSearch termSearch COVID-19 is an emerging, rapidly evolving situation. Journal ListHSS Jv.9(1); 2013 FebPMC3640710 HSS J. 2013 Feb; 9(1): 96–99. Published online 2012 Nov 9. doi: 10.1007/s11420-012-9282-z Successful Treatment of a Recalcitrant Pleural Effusion with Rib Fracture Fixation Benjamin C. Taylor, MD and Bruce G. French, MD Pulmonary complications of rib fractures typically occur in the immediate postinjury period, as a result of the forces causing the injury or subsequent rib fracture displacement. Pneumothorax, hemothorax, pulmonary contusions, or parenchymal lacerations are frequently seen with significant chest wall trauma. Hemopneumothorax is typically treated with tube thoracostomy, and full resolution of the pleural injury is expected; continued pleural fluid accumulation despite these measures is unanticipated, rare, and quite problematic. We report a case of hemorrhagic pleural effusion after rib fractures that were recurrent despite several tube thoracostomies and computed tomography-guided aspirations. The patient subsequently underwent operative fixation of her rib fractures, with successful resolution of her symptomatic pleural effusion. Keywords: rib fracture, flail chest, pleural effusion, rib fixation, chest wall injury Rib fractures are typically the result of blunt force trauma and can be associated with significant pulmonary dysfunction and even increased mortality rates [3]. Although long-term disability has been reported with nonoperative management of rib fractures [2] morbidity is generally seen upon initial presentation, with little currently reported on delayed complications of rib fractures. Prolonged thoracic weakness, impaired respiratory function, and chronic pain have been noted at long-term evaluation of patients who underwent conservative treatment of flail chest and/or multiple rib fractures [2]

Pleural Thickening of Lungs: Causes, Symptoms & Treatment


Pleural thickening, also known as diffuse pleural thickening, is a lung disease in which extensive scarring thickens the pleura, which is the lining of the lungs. Mesothelioma / Related Conditions / Pleural Thickening Pleural Thickening and Asbestos Pleural thickening, also known as diffuse pleural thickening, is a lung disease in which extensive scarring thickens the pleura, which is the lining of the lungs. The condition may cause chest pain and breathing difficulty, and it is one of the most commonly diagnosed signs of asbestos exposure. FREE PLEURAL MESOTHELIOMA GUIDE Pleural thickening is an asbestos-related disease that, as the name implies, thickens the pleura with scar tissue. Early pleural thickening has no symptoms, however, as more and more rigid pleural scarring forms around the lungs, it becomes harder for them to fully expand when breathing. As the disease progresses, patients commonly experience chest pain and breathlessness, which is also known as dyspnea. Symptoms may include chest pain and breathing difficulty. Caused by asbestos exposure and associated with pleural effusions. Also caused by conditions that inflame the pleural lung lining. Treated with medication and pulmonary rehabilitation. Pleural thickening can be serious, especially when it reaches more advanced stages. The presence of pleural thickening is not enough to confirm a pleural mesothelioma diagnosis, but it can be a sign of serious and significant asbestos exposure. Because catching mesothelioma in an early stage can lead to a wider range of treatment options, patients with asbestos-related pleural thickening should seek regular cancer screening. Advanced pleural thickening may close off the space between the two layers of the pleura and encase the lung completely, causing restrictive lung disease. As a result, patients experience decreased lung volume and have to work harder to breathe.

Rib Fracture Imaging: Overview, Radiography, Computed Tomography


Nov 9, 2016 ... Thoracic trauma may present as an isolated rib fracture, a chest ... can cause bleeding into the pleural cavity and result in a pneumothorax (see the ... in the chest-wall muscles may be seen as thickening of the pleural space, ... This site is intended for healthcare professionals Author: Lennard A Nadalo, MD, FACR; Chief Editor: Felix S Chew, MD, MBA, MEd  more... Thoracic trauma may present as an isolated rib fracture, a chest contusion, or a laceration; however, significant thoracic trauma often involves multiple organ systems and several anatomic regions. [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13] The chest trauma that results from a motor vehicle accident may result in injury to the sternum, the ribs, and the heart, aorta, and lungs. Multiple injuries often occur in people who are involved in traffic accidents, and rib fractures are among the most common of these injuries, with an occurrence as high as 60%. Radiography of the chest should be a routine part of autopsies of patients who die of injuries that result from traffic accidents. [14] Radiographs can depict bony trauma, and rib fractures are among the most commonly identified injuries to the chest. Injuries to the chest wall may involve the pleural space, lungs, extrapleural space, mediastinum, heart and great vessels, spine, and shoulders. To continue reading this article ... Related Conditions and Diseases Wrist Fractures and Dislocations General Principles of Internal Fixation Poor Adherence to Evidence-Based Treatments for Traumatic Rib Fractures AI Tool Improves Detection of Bone Fractures on X-rays Fracture Risk Appears Higher With PPIs Than With H2RAs 14 Can't-Miss Hand Emergencies How Radiology Is Rethinking Lead Aprons Radiology Must Adapt to New Pandemic

Chest X-ray Abnormalities - Pleural disease ***** Some diseases of the pleura cause pleural thickening, and others lead to fluid or air ... cause is trauma, with laceration of the visceral pleura by a fractured rib.


Cardiac contour and pulmonary oedema The pleura and pleural spaces are only visible when abnormal There should be no visible space between the visceral and parietal pleura Check for pleural thickening and pleural effusions If you miss a tension pneumothorax you risk your patient's life – as well as your result at finals! The pleura only become visible when there is an abnormality present. Pleural abnormalities can be subtle and it is important to check carefully around the edge of each lung where pleural abnormalities are usually more easily seen. Some diseases of the pleura cause pleural thickening, and others lead to fluid or air gathering in the pleural spaces. A pneumothorax forms when there is air trapped in the pleural space. This may occur spontaneously, or as a result of underlying lung disease. The most common cause is trauma, with laceration of the visceral pleura by a fractured rib.If the lung edge measures more than 2 cm from the inner chest wall at the level of the hilum, it is said to be 'large.' If there is tracheal or mediastinal shift away from the pneumothorax, the pneumothorax is said to be under 'tension.' This is a medical emergency! Missing a tension pneumothorax may not only harm your patient, it is also the quickest way to fail the radiology OSCE at finals! Tap on/off image to show/hide findings Visible pleural edge (blue line) Lung markings not visible beyond this edge Fall from height - trauma to chest Left pneumothorax due to a rib fracture (arrowhead)