5. How would you investigate a patient with a suspected fractured rib?
Correct answer:
Chest X-ray may confirm rib fractures, and will identify underlying lung damage or haemorrhage that might not have been suspected from the trivial nature of the patient’s symptoms. A chest X-ray may not always demonstrate a fracture, and, if the patient has clinical signs of fractured ribs, he should be treated for this condition in spite of a negative X-ray. A repeat X-ray at 2 weeks may show a fracture callus to confirm the diagnosis. Bone scan is more sensitive at detecting fractures, especially pathological fractures, when it may reveal metastatic tumour deposits elsewhere in the skeleton, or be suggestive of metabolic bone disease.
