The CXR shows many rib deformities due to old fracturees. When a rib fracture heals, the callus formation may create a mass-like appearance (blue arrow). Sometimes a CT is necessary to differentiate a healing fracture from a lung mass. Notice the large lung volume and the enlarged pulmonary vessels.When is a rib series indicated in the evaluation of chest pain?
Currently, a standard chest x-ray is often the initial study of choice in evaluation of chest pain and in cases of minor blunt trauma. If rib fractures are suspected clinically, performing a rib series can be of benefit.What does more than 7 ribs on a chest X-ray mean?
More than 7 ribs suggests lung hyper-expansion On this normal X-ray the anterior end of the 7th rib (asterisk) intersects the diaphragm at the mid-clavicular line The subcostal grooves are visible on the underside of the ribs (red highlights) These grooves contain the subcostal nerves and vessels that accompany each ribHow are rib fractures identified in Xray?
So most rib fractures are identified using plain old chest xray. Sometimes they are obvious, as in the image of a flail chest below. But sometimes, there are only a few and they are hard to distinguish, especially if the are located laterally.