Re: They aren't broken after all! - - Please Read

[Guest guest]

Turns out, after a call from the clinic, that the radiologist says

they aren't broken. So, it must be costochondritis.

------------------

This may or may not make more sense. Remember my first post

(actually the one that came in second after some kind of

cyberdelay)? Where I asked how they determined that the ribs were

broken - xray versus palpation?

There are three basic kinds of fracture: hairline, simple and

compound. A hairline fracture is a crack in the bone but with no

displacement of bone at the fracture line. A simple fracture

involves displacement of bone ends at the fracture line but without

piercing the skin. A compound fracture has a displaced bone end

that actually break through the skin.

Xrays are worthless for hairline fractures until about a week after

the injury because the fracture line or crack will not show up on

the xray until the bone starts to actually knit back together. I

have personally gone through this on three separate occasions: my

right big toe, tarsal bones in the top of my right foot, and my ribs

the first time I broke them. The toe was about ten years ago, the

foot about five or six years ago and the first rib episode not quite

two years ago. All three cases started with hairline fractures.

My first aid training told me in all three cases that I had a

fracture, and this was determined by palpation and pain sensation.

Specifically, one of the body's defense mechanisms is that the

muscles in the fracture area will contract very tightly to support

and protect the bone. There may or may not be significant swelling,

but the area is very " hard " to the touch. The other clue for me

personally was the pain sensation. I have noticed in every case of

a fracture that the pain sensation is very distinct - it is very

localized, very precise, and like a very sharp, tingling, compared

to a muscle spasm that tends to cover a wider area and be more

diffused.

In all three cases, I followed the typical advice " you better go see

a doctor and get that xrayed. " And in all three cases, they took

the xrays and said - " nope - no fracture. " Also in all three cases,

I ended up having not less than three xrays taken over a period of

about two weeks. Xrays one and two got " no fracture. " Xray three

got " well, I'll be - you were right afterall - it was broken. "

A simple fracture will show up on an xray because you can see the

actual displacement of bone; a hairline won't. Unfortunately,

hairlines have a habit of turning into simple fractures if you are

not careful. Again, been there, done that ... three times: toe,

foot and ribs. I also ended up rebreaking every one of them

multiple times over about four months each before they finally

healed.

My " confusion " when you first posted about Lindsey's ribs was the

timing. If she had in fact fractured her ribs the day before from

coughing (which can definitely happen), it was too soon for a

hairline fracture to show up on the xrays. A determination of

fracture for me then would have meant that they either detected it

by palpation OR it was a simple, displaced bone, fracture that did

show up. I assumed from your comment about feeling a " lump " where

it hurt that it was either contracted muscle to protect the area or

was a simple displacement.

As for being " costochondritis, " I don't think so. It depends again

on where it hurts. Costochondritis is an inflammation of the costo

cartilage - as in the cartilaginous connection of the rib to the

sternum. She could be having an inflammation of the intracostal

muscles in other areas, but that wouldn't be true costochondritis.

Her symptoms, however, argue against that. Specifically, she

coughed and she had instant pain. It is possible that she pulled or

strained one or more of the intracostals in doing it but that would

not be typical.

If she did get a " muscle pull " I would expect the pain level to be

relatively constant. It would hurt all the time, but with varying

degrees of intensity depending on whether she is moving or twisting

to put more or less stress on the area. A hairline fracture by

comparison gives sporadic but very intense pain. It only " grabs "

when stress or tension is put on the fracture line. But when it

does grab, it feels like something straight out of Dante's Inferno.

To wrap things up, it still sounds more like hairline fractures than

anything else. The safest thing she can do is to act like they are

fractured for at least ten days to two weeks after the initial

episode. In my mind, the jury is still out on the question. She does

not want to do anything to restress that area just in case because

she doesn't want to go from hairline to simple. And the best advice

I can give is to be absolutely certain to properly brace herself in

a locked position if she feels a cough or sneeze coming on.

[Guest guest]

Turns out, after a call from the clinic, that the radiologist says

they aren't broken. So, it must be costochondritis.

------------------

This may or may not make more sense. Remember my first post

(actually the one that came in second after some kind of

cyberdelay)? Where I asked how they determined that the ribs were

broken - xray versus palpation?

There are three basic kinds of fracture: hairline, simple and

compound. A hairline fracture is a crack in the bone but with no

displacement of bone at the fracture line. A simple fracture

involves displacement of bone ends at the fracture line but without

piercing the skin. A compound fracture has a displaced bone end

that actually break through the skin.

Xrays are worthless for hairline fractures until about a week after

the injury because the fracture line or crack will not show up on

the xray until the bone starts to actually knit back together. I

have personally gone through this on three separate occasions: my

right big toe, tarsal bones in the top of my right foot, and my ribs

the first time I broke them. The toe was about ten years ago, the

foot about five or six years ago and the first rib episode not quite

two years ago. All three cases started with hairline fractures.

My first aid training told me in all three cases that I had a

fracture, and this was determined by palpation and pain sensation.

Specifically, one of the body's defense mechanisms is that the

muscles in the fracture area will contract very tightly to support

and protect the bone. There may or may not be significant swelling,

but the area is very " hard " to the touch. The other clue for me

personally was the pain sensation. I have noticed in every case of

a fracture that the pain sensation is very distinct - it is very

localized, very precise, and like a very sharp, tingling, compared

to a muscle spasm that tends to cover a wider area and be more

diffused.

In all three cases, I followed the typical advice " you better go see

a doctor and get that xrayed. " And in all three cases, they took

the xrays and said - " nope - no fracture. " Also in all three cases,

I ended up having not less than three xrays taken over a period of

about two weeks. Xrays one and two got " no fracture. " Xray three

got " well, I'll be - you were right afterall - it was broken. "

A simple fracture will show up on an xray because you can see the

actual displacement of bone; a hairline won't. Unfortunately,

hairlines have a habit of turning into simple fractures if you are

not careful. Again, been there, done that ... three times: toe,

foot and ribs. I also ended up rebreaking every one of them

multiple times over about four months each before they finally

healed.

My " confusion " when you first posted about Lindsey's ribs was the

timing. If she had in fact fractured her ribs the day before from

coughing (which can definitely happen), it was too soon for a

hairline fracture to show up on the xrays. A determination of

fracture for me then would have meant that they either detected it

by palpation OR it was a simple, displaced bone, fracture that did

show up. I assumed from your comment about feeling a " lump " where

it hurt that it was either contracted muscle to protect the area or

was a simple displacement.

As for being " costochondritis, " I don't think so. It depends again

on where it hurts. Costochondritis is an inflammation of the costo

cartilage - as in the cartilaginous connection of the rib to the

sternum. She could be having an inflammation of the intracostal

muscles in other areas, but that wouldn't be true costochondritis.

Her symptoms, however, argue against that. Specifically, she

coughed and she had instant pain. It is possible that she pulled or

strained one or more of the intracostals in doing it but that would

not be typical.

If she did get a " muscle pull " I would expect the pain level to be

relatively constant. It would hurt all the time, but with varying

degrees of intensity depending on whether she is moving or twisting

to put more or less stress on the area. A hairline fracture by

comparison gives sporadic but very intense pain. It only " grabs "

when stress or tension is put on the fracture line. But when it

does grab, it feels like something straight out of Dante's Inferno.

To wrap things up, it still sounds more like hairline fractures than

anything else. The safest thing she can do is to act like they are

fractured for at least ten days to two weeks after the initial

episode. In my mind, the jury is still out on the question. She does

not want to do anything to restress that area just in case because

she doesn't want to go from hairline to simple. And the best advice

I can give is to be absolutely certain to properly brace herself in

a locked position if she feels a cough or sneeze coming on.

[Guest guest]

Turns out, after a call from the clinic, that the radiologist says

they aren't broken. So, it must be costochondritis.

------------------

This may or may not make more sense. Remember my first post

(actually the one that came in second after some kind of

cyberdelay)? Where I asked how they determined that the ribs were

broken - xray versus palpation?

There are three basic kinds of fracture: hairline, simple and

compound. A hairline fracture is a crack in the bone but with no

displacement of bone at the fracture line. A simple fracture

involves displacement of bone ends at the fracture line but without

piercing the skin. A compound fracture has a displaced bone end

that actually break through the skin.

Xrays are worthless for hairline fractures until about a week after

the injury because the fracture line or crack will not show up on

the xray until the bone starts to actually knit back together. I

have personally gone through this on three separate occasions: my

right big toe, tarsal bones in the top of my right foot, and my ribs

the first time I broke them. The toe was about ten years ago, the

foot about five or six years ago and the first rib episode not quite

two years ago. All three cases started with hairline fractures.

My first aid training told me in all three cases that I had a

fracture, and this was determined by palpation and pain sensation.

Specifically, one of the body's defense mechanisms is that the

muscles in the fracture area will contract very tightly to support

and protect the bone. There may or may not be significant swelling,

but the area is very " hard " to the touch. The other clue for me

personally was the pain sensation. I have noticed in every case of

a fracture that the pain sensation is very distinct - it is very

localized, very precise, and like a very sharp, tingling, compared

to a muscle spasm that tends to cover a wider area and be more

diffused.

In all three cases, I followed the typical advice " you better go see

a doctor and get that xrayed. " And in all three cases, they took

the xrays and said - " nope - no fracture. " Also in all three cases,

I ended up having not less than three xrays taken over a period of

about two weeks. Xrays one and two got " no fracture. " Xray three

got " well, I'll be - you were right afterall - it was broken. "

A simple fracture will show up on an xray because you can see the

actual displacement of bone; a hairline won't. Unfortunately,

hairlines have a habit of turning into simple fractures if you are

not careful. Again, been there, done that ... three times: toe,

foot and ribs. I also ended up rebreaking every one of them

multiple times over about four months each before they finally

healed.

My " confusion " when you first posted about Lindsey's ribs was the

timing. If she had in fact fractured her ribs the day before from

coughing (which can definitely happen), it was too soon for a

hairline fracture to show up on the xrays. A determination of

fracture for me then would have meant that they either detected it

by palpation OR it was a simple, displaced bone, fracture that did

show up. I assumed from your comment about feeling a " lump " where

it hurt that it was either contracted muscle to protect the area or

was a simple displacement.

As for being " costochondritis, " I don't think so. It depends again

on where it hurts. Costochondritis is an inflammation of the costo

cartilage - as in the cartilaginous connection of the rib to the

sternum. She could be having an inflammation of the intracostal

muscles in other areas, but that wouldn't be true costochondritis.

Her symptoms, however, argue against that. Specifically, she

coughed and she had instant pain. It is possible that she pulled or

strained one or more of the intracostals in doing it but that would

not be typical.

If she did get a " muscle pull " I would expect the pain level to be

relatively constant. It would hurt all the time, but with varying

degrees of intensity depending on whether she is moving or twisting

to put more or less stress on the area. A hairline fracture by

comparison gives sporadic but very intense pain. It only " grabs "

when stress or tension is put on the fracture line. But when it

does grab, it feels like something straight out of Dante's Inferno.

To wrap things up, it still sounds more like hairline fractures than

anything else. The safest thing she can do is to act like they are

fractured for at least ten days to two weeks after the initial

episode. In my mind, the jury is still out on the question. She does

not want to do anything to restress that area just in case because

she doesn't want to go from hairline to simple. And the best advice

I can give is to be absolutely certain to properly brace herself in

a locked position if she feels a cough or sneeze coming on.

[Guest guest]

Thanks Mike. I agree. But, I swear the xray looked unusual. Those

nice smooth lines of the bones wern't nice and smooth in the areas

that are hurting. It looked like a fracture to me. but, I'm not an

expert. And, I've been told that costrochondritis is around the

sternum, and doesn't show on an xray.

-------------

You are welcome.

I can't read xrays worth beans myself and know what you mean about

not being an expert and relying on what the " experts " tell you.

All I know from quite a bit of experience with this sort of thing is

that all of the symptoms are very suggestive and strongly point

toward hairline fractures. I have spent several hundred dollars over

the years for " xray confirmation " that turned out to be wrong

afterall.

And as for treating it - " they " aren't going to do anything for it

anyway other than presribe meds to control the pain. Whether to

wear a rib brace or not is a matter of choice, regardless of what

the doctor told you about their current approach to not wrap.

During my first episode with broken ribs, a rib brace/strap was an

absolute god-send. I don't think I could have gotten through it

without one. It made all the difference for me.

This last time, however, the brace seemed to put the wrong kind of

pressure on the ribs and I couldn't tolerate it at all.

Either way, the purpose for using one is to stablize the ribs,

particularly so you don't do any sudden movement that snaps them.

You are also right - treating the situation as if they are broken

will not cause any harm at all. It is just a preventative to try to

make sure that, if they are broken they don't get worse, and if not

broken that they don't get broken.

[Guest guest]

Thanks Mike. I agree. But, I swear the xray looked unusual. Those

nice smooth lines of the bones wern't nice and smooth in the areas

that are hurting. It looked like a fracture to me. but, I'm not an

expert. And, I've been told that costrochondritis is around the

sternum, and doesn't show on an xray.

-------------

You are welcome.

I can't read xrays worth beans myself and know what you mean about

not being an expert and relying on what the " experts " tell you.

All I know from quite a bit of experience with this sort of thing is

that all of the symptoms are very suggestive and strongly point

toward hairline fractures. I have spent several hundred dollars over

the years for " xray confirmation " that turned out to be wrong

afterall.

And as for treating it - " they " aren't going to do anything for it

anyway other than presribe meds to control the pain. Whether to

wear a rib brace or not is a matter of choice, regardless of what

the doctor told you about their current approach to not wrap.

During my first episode with broken ribs, a rib brace/strap was an

absolute god-send. I don't think I could have gotten through it

without one. It made all the difference for me.

This last time, however, the brace seemed to put the wrong kind of

pressure on the ribs and I couldn't tolerate it at all.

Either way, the purpose for using one is to stablize the ribs,

particularly so you don't do any sudden movement that snaps them.

You are also right - treating the situation as if they are broken

will not cause any harm at all. It is just a preventative to try to

make sure that, if they are broken they don't get worse, and if not

broken that they don't get broken.