Conditions
What is a chest injury?
Chest wall injuries can be divided according to the part of the chest affected and so can be described as a rib, sternal or more complex chest wall injury. Non-traumatic chest wall problems can also occur and include specific conditions such as Costochondritis or Slipped Rib Syndrome. Other common injuries related to the chest include shoulder (scapula) collar bone (clavicle) as well as the thoracic spine. In addition, the chest wall injury or problem may be associated with other ‘underlying’ thoracic or lung problems causing breathing issues, such as a build of fluid in the chest (pleural effusion) or infections. Complex chest wall injuries refer to an injury to the chest often at a 'junction' between the sternum and the rib or rib and costal cartilage part of the chest or an injury to part of the lower rib cage called the costal margin. These injuries can be subtle and often hard to diagnosis and treat.
The skeleton showing the bony part of the chest from the front, side and back with thoracic spine highlighted in blue.
Rib and chest wall injuries are common and can be caused by many different traumatic or sports related accidents. They vary in severity from simple chest wall bruising to multiple rib breaks or fractures and associated internal or other injuries. Symptoms vary depending on severity of injury, but pain and discomfort are very common, is often protracted and can be worse with certain activities and movements. Breathing can be affected, leading to inability to exercise or even work as well as causing sleep problems. Management options are wide and varied and include simple diagnosis of the problem and reassurance to the need for surgery to correct the problem.
Types
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Rib injury
The most common chest wall injury. It can vary from a minor ‘bruising’ of the ribs to multiple and badly broken ribs. Pain is common and can affect daily activities.
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Sternal injury
An injury to the breastbone or sternum is usually caused by a direct ‘blunt force’ to the front of the chest. Pain can be severe and lead to breathing problems.
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Complex chest wall injuries
More subtle injuries of the chest can happen and are difficult to diagnosis and are often associated with chronic pain and disability.
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Chest wall lumps
More unusual chest wall problems can cause swelling and development of a lump, leading to pain, affect daily activities or lead to concerns around cancerous growths
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Chest wall pain
Costochondritis is inflammation of the costal cartilage of the rib cage and along with other inflammatory conditions is an important cause of pain and discomfort
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Slipped rib syndrome
Occurs when cartilage of the lower ribs move leading to pain in the chest or upper abdomen. It’s believed to be a result of hypermobility of the rib cartilage or ligaments, particularly ribs 8 to 10.
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Other associated problems
Other injuries associated with chest wall trauma include injuries or problems to the collar bone, shoulder blade and thoracic spine.