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Le Thanh Liem, Nguyen Thien Hung, Le van Tai, Lu Minh Tan, Le Tu Phuc, Phan Thanh Hai MEDIC MEDICAL CENTER, HCMC, Vietnam
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To disclose chondral or bony rib fracture by ultrasound which are negative on X-ray film of minor blunt chest trauma patients.
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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.
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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.
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Bony rib fractures with a disruption of continuity of bony cortex.
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Bruised chrondral rib with echogenic line in chondral part of rib.
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Chondral rib fracture by ox kicking for 4 days.
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2 cases of bruised chondral rib by hitting with echogenic area (L) and echogenic line (R).
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Calcification of chondral rib post trauma for 4 years but no evidence on chest X-ray film
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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.