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This patient is a 14 year old female status post MVA. The following radiograph was taken. Questions: 1. Describe what you see? AP view if the cervical spine. Fracture of the first right rib. Diagnosis: Fracture of the first right rib. 2. What is the significance of this x ray? First rib fractures are associated with severe trauma. Since the first rib is very well protected by the clavicle, shoulder, and lower neck musculature, it requires a much higher force on impact to fracture than the other ribs. Children’s ribs are more elastic and are less likely than adult’s ribs to sustain fractures following blunt chest trauma. This makes rib fractures in children even more of an ominous sign. 3. What complications can this patient be expected? Complications include injuries to the lung, ascending aorta, subclavian artery and brachial plexus, with a mortality rate as high as 36%. Trivia: Which group took their name from a 17th century agriculturalist, best known for inventing the seed drill? Answer: Jethro Tull.
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