Rib fractures

Case history #1

An 86-year-old woman is admitted following a fall at home. She is complaining of chest pain and shortness of breath. On exam there is shallow respiratory effort, raised respiratory rate, and tenderness on palpation of the chest wall. Percussion of the lower left chest is dull, suggestive of hemothorax.

Case history #2

A 3-year-old boy presents to the ER for irritability and chest pain. The mother denies any known injury and does not know what precipitated the complaints. Physical exam shows a well-nourished child in no significant distress. He has two small bruises on his buttocks and a small bruise over his left mid-chest wall, which are tender to palpation. Apart from the tenderness, he has a normal exam.

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