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Reading M. Chest X-ray quiz. The deep sulcus sign. Intensive Crit Care Nurs 2005; 20:378-9. [PMID: 15648118 DOI: 10.1016/j.iccn.2004.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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77
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Khriakov AS, Esetov AK, Razumov AN, Shubin IV. [Perforating shotgun wound of the abdomen with injuries multiple visceral]. Khirurgiia (Mosk) 2005:65-6. [PMID: 15704313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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78
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Mashiba T, Mori S, Burr DB, Komatsubara S, Cao Y, Manabe T, Norimatsu H. The effects of suppressed bone remodeling by bisphosphonates on microdamage accumulation and degree of mineralization in the cortical bone of dog rib. J Bone Miner Metab 2005; 23 Suppl:36-42. [PMID: 15984412 DOI: 10.1007/bf03026321] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We evaluated the effects of suppressed bone remodeling caused by bisphosphonate on microdamage accumulation and degree of mineralization of bone (DMB) for the dog rib in two independent studies. Study 1: 36 female beagles, 1-2 years old, were treated daily for 1 year with saline vehicle, risedronate at 0.5 mg/kg/day, or alendronate at 1.0 mg/kg/day. Study 2: 29 beagles, 1 year old, were given lactose, or incadronate at 0.3 mg/kg/day or 0.6 mg/kg/day for 3 years. In both studies, the ninth rib was harvested. Intracortical remodeling was significantly suppressed following either 1 year or 3 years of bisphosphonate treatment without impairment of primary mineralization, although the remodeling rate was obviously lower in study 2 than in study 1 because of the aging of animals. Microdamage accumulation was significantly increased following any bisphosphonate treatment in response to the extent of remodeling suppression. One-year treatment with risedronate or alendronate did not significantly affect the mean DMB or osteonal distribution based on DMB. In contrast, mean DMB was significantly increased following 3 years of incadronate treatments, and osteonal distributions based on DMB showed a dose-dependent shift toward the higher values in incadronate-treated animals when compared with controls. Our results demonstrated that DMB was increased following only 3 years but not 1 year of bisphosphonate treatment. This finding suggests that suppressed remodeling induced by long-term bisphosphonate treatment increased DMB by increasing the population of old, highly mineralized osteons; however, the expression of this phenomenon depends on duration of the treatment because the secondary mineralization is a very slow process.
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79
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Sprague LD, Ferrigni FJ. Images in clinical medicine. Lung herniation after cardiopulmonary resuscitation. N Engl J Med 2004; 351:695. [PMID: 15306671 DOI: 10.1056/nejmicm030736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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80
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Masroor S, Tehrani H, Pham S, Neijman T, Martinez-Ruiz R, McKenney M, Salerno T. Extracorporeal Life Support in Pulmonary Failure after Traumatic Rupture of the Thoracic Aorta: A Case Report. ACTA ACUST UNITED AC 2004; 57:389-91. [PMID: 15345991 DOI: 10.1097/01.ta.0000037285.52097.8c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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81
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Gilbert O, Pierard P, Quarré JP, Thiriaux J, Lauwers D, Rocmans P. [Delayed right diaphragmatic rupture: a breathtaking picture!]. Rev Mal Respir 2004; 21:411-3. [PMID: 15211255 DOI: 10.1016/s0761-8425(04)71305-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
MESH Headings
- Accidental Falls
- Diagnosis, Differential
- Diaphragm/injuries
- Female
- Fractures, Bone/diagnosis
- Fractures, Bone/etiology
- Hernia, Diaphragmatic, Traumatic/diagnosis
- Hernia, Diaphragmatic, Traumatic/etiology
- Hernia, Diaphragmatic, Traumatic/surgery
- Humans
- Laparotomy
- Magnetic Resonance Imaging
- Middle Aged
- Multiple Trauma/diagnosis
- Multiple Trauma/etiology
- Multiple Trauma/surgery
- Ribs/injuries
- Rupture
- Thoracotomy
- Tomography, X-Ray Computed
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82
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Falcón Panella I, Force Sanmartín L, Hernández JA. [Post-traumatic eosinophilic pleural effusion]. ACTA ACUST UNITED AC 2004; 21:47-8. [PMID: 15195491 DOI: 10.4321/s0212-71992004000100016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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83
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Abstract
Fractures of the first rib are uncommon in athletes and present a different clinical entity from traumatic first rib fracture associated with high energy thoracic trauma. These fractures are stress induced and precipitated by chronic muscular forces acting on the first rib. Typically they heal with conservative treatment. This report describes a fracture of the first rib in a tennis player that developed into a symptomatic pseudarthrosis as a result of persistent overhead activities. Symptoms mimicked ipsilateral shoulder injury. Pseudarthrosis of the first rib should be included in the differential diagnosis of chronic persistent shoulder pain in the overhead athlete.
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Peterson LL, Cavanaugh DG. Two Years of Debilitating Pain in a Football Spearing Victim: Slipping Rib Syndrome. Med Sci Sports Exerc 2003; 35:1634-7. [PMID: 14523297 DOI: 10.1249/01.mss.0000089249.00206.04] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Blunt chest trauma can occur in a variety of sports, and lead to rib fractures and less commonly known and diagnosed injuries. We report the case of a 14-yr-old student athlete who was speared (helmet tackled) in a practice scrimmage sustaining a painful injury that eluded diagnosis and treatment for more than 2 yr. METHODS The case history of pain treatments and radiological evaluations is presented. RESULTS Ultimately, a definitive diagnosis of "slipping rib syndrome" was achieved through a simple clinical manipulation (the hooking maneuver), combined with a history of symptomatic relief provided with costochondral blockade. Surgical resection of the slipping rib provided total resolution of the problem. CONCLUSION Very few clinicians are aware either of the syndrome or the maneuver used to diagnose this condition. Although spearing has been outlawed in American football for years, it remains a commonplace occurrence, and sports physicians should be aware of the potential consequences to the victim as well as those to the perpetrator.
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86
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Abstract
Thoracic and lumbar injuries can dramatically affect a rower's performance and lead to time lost from practice and competition. Even though the number of injuries encountered by elite and competitive rowers appears to have increased over the past 20 years, rowing-specific research has been very limited in its scope and ability to guide practitioners caring for these athletes. Specifically, case reports relating to rib stress fractures abound, yet very few controlled studies discuss the mechanisms of injury and appropriate management of thoracic injuries. We believe that the identification and treatment of kinetic chain abnormalities in areas distant to the site of injury, such as the lower extremities, pelvis, and lumbar spine, should be an integral part of thoracic injury evaluation and treatment. Simultaneous evaluation of training regimen and equipment is also crucial to the management of rowers suffering from thoracic injuries.
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87
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Ibáñez Godoy I, Mora Navarro D, Delgado Rioja MA, Herrera del Rey C. [Isolated obstetric costal fractures]. An Pediatr (Barc) 2003; 58:612. [PMID: 12781121 DOI: 10.1016/s1695-4033(03)78131-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Bergeron E, Lavoie A, Clas D, Moore L, Ratte S, Tetreault S, Lemaire J, Martin M. Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. THE JOURNAL OF TRAUMA 2003; 54:478-85. [PMID: 12634526 DOI: 10.1097/01.ta.0000037095.83469.4c] [Citation(s) in RCA: 232] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this study was to show that elderly patients admitted with rib fractures after blunt trauma have increased mortality. METHODS Demographic, injury severity, and outcome data on a cohort of consecutive adult trauma admissions with rib fractures to a tertiary care trauma center from April 1, 1993, to March 31, 2000, were extracted from our trauma registry. RESULTS Among 4,325 blunt trauma admissions, there were 405 (9.4%) patients with rib fractures; 113 were aged > or = 65. Injuries were severe, with Injury Severity Score (ISS) > or = 16 in 54.8% of cases, a mean hospital stay of 26.8 +/- 43.7 days, and 28.6% of patients requiring mechanical ventilation. Mortality (19.5% vs. 9.3%; p < 0.05), presence of comorbidity (61.1% vs. 8.6%; p < 0.0001), and falls (14.6% vs. 0.7%; p < 0.0001) were significantly higher in patients aged > or = 65 despite significantly lower ISS (p = 0.031), higher Glasgow Coma Scale score (p = 0.0003), and higher Revised Trauma Score (p < 0.0001). After adjusting for severity (i.e., ISS and Revised Trauma Score), comorbidity, and multiple rib fractures, patients aged > or = 65 had five times the odds of dying when compared with those < 65 years old. CONCLUSION Despite lower indices of injury severity, even after taking account of comorbidities, mortality was significantly increased in elderly patients admitted to a trauma center with rib fractures.
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Abstract
The symptom of chest pain in the athlete can represent anything from a nonspecific musculoskeletal strain to a life-threatening condition such as tension pneumothorax. For the physician charged with evaluating this patient population, a thorough knowledge of the possible etiologies, their usual diagnostic algorithms, available imaging modalities, and potential therapeutic options is essential. Although the vast majority of patients with traumatic chest pain will not harbor significant pathology, the clinician must be prepared for those few who do have such conditions, and be prepared to intervene in an appropriate, time-sensitive fashion.
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91
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Sukkarieh F, Vanmeerhaeghe A, Brasseur P. [Post traumatic intercostal lung herniation: a case report]. JOURNAL DE RADIOLOGIE 2002; 83:1085-7. [PMID: 12223919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The authors report a case of post traumatic lung herniation in a 76 year old obese retired coalminer with chronic obstructive pulmonary disease. Lung herniation is a rare event. It is typically is iatrogenic or post traumatic and sometimes occurs after a delay of several months or years. CT is useful for diagnosis.
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92
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de Gruchy S, Rogers TL. Identifying chop marks on cremated bone: a preliminary study. J Forensic Sci 2002; 47:933-6. [PMID: 12353576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The purpose of this analysis is to evaluate the effects of burning on hacking trauma inflicted with a cleaver and to assess the diagnostic potential of cleaver marks exposed to fire. Thirty pig forelimbs (radius and ulna) and 30 beef ribs were each subjected to five blows with a cleaver and five cuts with a knife prior to burning in an outdoor fire. Bones were deliberately agitated to ensure maximum cremation and induce fragmentation. Results indicate that hacking weakens bone, making fire-induced fragmentation more likely at the sites of trauma. Chop marks were easily identified on burned bone, their characteristics largely unaffected by cremation.
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93
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Abstract
Chest pain in the athlete has a wide differential diagnosis. Pain may originate from structures within the thorax, such as the heart, lungs or oesophagus. However, musculoskeletal causes of chest pain must be considered. The aim of this review is to help the clinician to diagnose chest wall pain in athletes by identifying the possible causes, as reported in the literature. Musculoskeletal problems of the chest wall can occur in the ribs, sternum, articulations or myofascial structures. The cause is usually evident in the case of direct trauma. Additionally, athletes' bodies may be subjected to sudden large indirect forces or overuse, and stress fractures of the ribs caused by sporting activity have been extensively reported. These have been associated with golf, rowing and baseball pitching in particular. Stress fractures of the sternum reported in wrestlers cause pain and tenderness of the sternum, as expected. Diagnosis is by bone scan and limitation of activity usually allows healing to occur. The slipping rib syndrome causes intermittent costal margin pain related to posture or movement, and may be diagnosed by the 'hooking manoeuvre', which reproduces pain and sometimes a click. If reassurance and postural advice fail, good results are possible with resection of the mobile rib. The painful xiphoid syndrome is a rare condition that causes pain and tenderness of the xiphoid and is self-limiting. Costochondritis is a self-limiting condition of unknown aetiology that typically presents with pain around the second to fifth costochondral joints. It can be differentiated from Tietze's syndrome in which there is swelling and pain of the articulation. Both conditions eventually settle spontaneously although a corticosteroid injection may be useful in particularly troublesome cases. The intercostal muscles may be injured causing tenderness between the ribs. Other conditions that should be considered include epidemic myalgia, precordial catch syndrome and referred pain from the thoracic spine.
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Kara M, Alver G, Aksu O, Kavukçu S. Synovial cyst arising from pseudoarthrosis of a rib fracture following trauma. Eur J Cardiothorac Surg 2002; 21:338. [PMID: 11825747 DOI: 10.1016/s1010-7940(01)01128-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fiorentino L, Rossi G, Ruggiero C, Valli R, Gusolfino D, Massimiano M, Losi L, Barbolini G. [Parosteal rib lipoma: description of a case]. Pathologica 2001; 93:668-71. [PMID: 11785119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Parosteal lipoma is a usually indolent, rare benign tumor, characterized by clinicopathological findings similar to those of the commonly occurring subcutaneous lipoma, except for its intimate relationship with the connective tissue of the subjacent periosteal region. Parosteal lipoma commonly affects the diaphysis of long bones of the upper and lower limbs. We report an exceedingly rare case of parosteal lipoma of the rib, which presented in a 59-year-old man experiencing previous multiple traumas in this site.
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Blanco M, Cabello-Inchausti B, Cura M, Fernandes L. Post-traumatic fibro-osseous lesion of the ribs and scapula (sclerosing xanthofibroma). Ann Diagn Pathol 2001; 5:343-9. [PMID: 11745072 DOI: 10.1053/adpa.2001.29342] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fibrous lesions of bone may be difficult to classify. Their etiology is controversial, most being considered to be developmental lesions rather than true neoplasms. We describe a patient with post-traumatic fibro-osseous lesion of the ribs, also known as sclerosing xanthofibroma; a lesion believed to be a reactive response to intramedullary hemorrhage following chest wall trauma. Clinically, the lesions in our patient were thought to be metastatic disease because of their multifocal appearance. An extensive clinical and laboratory metastatic evaluation with surgical resection of one of the lesions using intraoperative gamma probe was undertaken. In addition to the multiple rib involvement, our case also showed a lesion in the scapula. The pathologic and radiologic features of this entity are reviewed along with the summary of the differential diagnosis.
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Lazarus HM, Price RS, Sorensen J. Dangers of large exotic pets from foreign lands. THE JOURNAL OF TRAUMA 2001; 51:1014-5. [PMID: 11706357 DOI: 10.1097/00005373-200111000-00033] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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98
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Walamies M. [Rib changes in a patient with breast cancer]. DUODECIM; LAAKETIETEELLINEN AIKAKAUSKIRJA 2001; 113:1683, 1685. [PMID: 10650638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Osawa H, Yoshii S, Takahashi W, Hosaka S, Ishikawa N, Mizutani E, Abraham SJ, Tada Y. Hemorrhagic shock due to intrathoracic rupture of an osteosarcoma of the rib. Ann Thorac Cardiovasc Surg 2001; 7:232-4. [PMID: 11578264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
A 13-year-old girl presented with dyspnea and chest pain. Chest radiography showed a massive left pleural effusion. Computed tomography revealed a tumor of the fourth rib. A large bloody effusion was drained. Her anemia worsened (hemoglobin: 4.8 g/dl), and hemorrhagic shock ensued. An emergency thoracotomy was performed. Bleeding from the ruptured tumor was identified. The fourth rib, the tumor, and the adjacent tissues were resected. Histopathologic examination revealed a ruptured primary osteosarcoma of the rib with pleural dissemination.
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