Chondral and Bony Rib Fracture in Relevation by Ultrasound

Le Thanh Liem, Nguyen Thien Hung, Le van Tai, Lu Minh Tan, Le Tu Phuc, Phan Thanh Hai MEDIC MEDICAL CENTER, HCMC, Vietnam

To disclose chondral or bony rib fracture by ultrasound which are negative on X-ray film of minor blunt chest trauma patients.

A total of 42 patients suffering from minor blunt chest trauma without evidence of a rib fracture on chest X-ray film, were examined with a 9L4 MHz or 7.5 MHz linear transducer of ultrasound system (Siemens, Aloka).

Statistical analysis was done to outline the ultrasound findings of these rib fractures.

42 patients (100.0%) showed chondral and bony rib lesions, but no evidence of rib lesions on X-ray film.

Fracture of the rib = disruption of continuity of bony cortex near chrondral and bony rib junction was the most common finding in  37 (88.0%) patients.

Chondral rib fractures were in five (11.9%) patients. Chondral rib fracture = disruption of cortex, small

echogenic lines in chondral rib, Bruised chondral rib = a small deformation of chondral

cortex and echogenic area at trauma site [painful site]. Bony rib fractures significantly occurred in trauma

patients, and the duration of pain in patients with chondral rib fractures was significantly longer than that of patients with bony rib fractures.

Bony rib fractures with a disruption of continuity of bony cortex.

Bruised chrondral rib with echogenic line in chondral part of rib.

Chondral rib fracture by ox kicking for 4 days.

2 cases of bruised chondral rib by hitting with echogenic area (L) and echogenic line (R).

Calcification of chondral rib post trauma for 4 years but no evidence on chest X-ray film

Ultrasonography is a useful imaging method in disclosing the rib fractures (chondral and bony rib fractures) which were negative on chest X-ray film in minor blunt chest trauma.

However, chondral rib fractures significantly occur less than bony rib fractures and result in a longer duration of pain.