Diagnostics

At the beginning of every diagnosis of rib contusion is the medical history, followed by a physical examination. The doctor palpates the ribs to find a contusion or a fracture. Usually there is a very strong pressure pain where the ribs are injured.

If a rib contusion is suspected, it is also important to rule out injuries to other organs and a possible rib fracture. In order to diagnose a rib contusion, depending on the severity of the injury, an X-ray image may be sufficient, or a computer tomography (CT) may be ordered.

In CT, not only the bony structures can be assessed, but also the internal organs, which is not possible with an X-ray image.
Only the bones can be assessed in the X-ray image.
It is therefore important to rule out the possibility of a rib fracture, since the lungs can be injured by the broken ribs and a pneumothorax can develop. A pneumothorax is an accumulation of air outside the lung in the thorax. If air enters between the lungs and the chest, this air can hinder the lungs in breathing and cause severe shortness of breath.

In some cases, it is then necessary to insert a chest tube.
In addition, an ECG can be written to rule out a cardiac injury in case of a rib contusion and the lungs can be listened to with a stethoscope.

There are several ways to distinguish a rib fracture from a rib contusion. In everyday clinical practice, this distinction is only of limited relevance. A fracture often requires a longer healing phase and can also be accompanied by more severe secondary diseases.

However, the treatment of the two injuries does not differ, as in both cases there is no causal therapy, but only pain relief over the duration of the healing phase. The simplest method to distinguish a fracture from a contusion is to palpate the ribs. Almost all ribs can be palpated in their full length.

Even though the examination is often painful, most fractures can already be identified this way. In addition, there is often a crunching noise when pressure is applied from outside or when taking deep breaths. To confirm the diagnosis, an x-ray or CT scan can be taken to identify the bones and potential fractures.