A rib contusion does not differ much from one that we can see on the skin after receiving a blow. However, this injury to the chest wall generates respiratory compromise.
The ribs are horizontally arranged bones, whose main function is to protect the organs located in the rib cage and in the upper part of the abdomen . They can suffer a wide variety of injuries, most notably rib contusion.
Human bones have 2 well-defined areas: a cortical and a trabecular. The trabecular region is much less rigid and more vascular than the other, making it more prone to injury.
In general terms, bruises are injuries caused by the rupture of blood vessels in a certain area. A rib contusion is nothing more than the rupture of some blood vessels in the trabecular area of the bone and the formation of a hematoma.
What are the symptoms?
The symptoms presented by patients with this type of injury does not vary much from that presented by people with a rib fracture. The characteristic symptom is pain in the affected area, which appears immediately after the blow.
Pain from a rib contusion can last 3-6 weeks, increasing with breathing movements. Other common symptoms that people may have are the following:
- Inflammation in the area of the injury.
- Change in skin color or cutaneous hematoma.
- Shortness of breath
- Muscle spasms on the affected side.
- Increased pain when coughing , sneezing, or moving.
Main causes of a rib contusion
Any situation that can injure the chest wall is capable of generating a rib contusion. In this sense, trauma is the most frequent cause . In fact, studies show that trauma-associated wall injuries are a major cause of morbidity and mortality.
In order for the blood vessels to rupture, there must be a direct transfer of energy to the bone surface. In this way, situations such as traffic accidents, falls or contact sports can be the origin.
There are other conditions capable of causing a rib contusion, such is the case of patients with chronic obstructive pulmonary disease (COPD) or the fact of lifting heavy objects. These situations generate an increase in intrathoracic pressure and can cause injury.
There are certain conditions that predispose people to bruise, despite not being a direct cause. These include some osteoarticular diseases, such as osteoporosis , which weakens bone tissue and makes it more prone to breakdown.
Pregnant women are also at higher risk of rib fractures and bruises from the enlarged uterus. Studies show that even the slightest blow or a coughing episode can cause such an injury.
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How do you make the diagnostic?
The diagnosis of a rib contusion is made with a questioning of the symptoms and a proper physical examination by the specialist. The doctor will ask about how the injury occurred and the symptoms that appeared after the injury.
It will also be necessary to listen to the patient’s breathing to verify that it is not affected. The specialist will inspect the area where the injury occurred in search of any hematoma, deformity or clinical finding of interest.
The symptoms of a contusion and a fracture are very similar , so a chest X-ray will be indicated. This exam will allow to establish the difference between both injuries.
Finally, other tests, such as an MRI or CT scan , may be necessary to rule out the presence of lesions in other organs and tissues.
Treating a rib contusion
Contusions are treated very similarly to rib fractures, so surgery is almost never necessary. However, the injury should not be bandaged because it would interrupt respiratory movements, increasing the risk of suffering from pneumonia .
In this sense, absolute rest is one of the main measures to promote proper bone regeneration. In case that is impossible, reducing daily activities and avoiding sudden movements is usually more than enough.
For his part, the doctor may also indicate the consumption of analgesic and anti-inflammatory drugs such as ibuprofen . In the most severe cases, a pain reliever may be injected near the injured area.
Respiratory physiotherapy can be useful for those patients with respiratory compromise. The exercises indicated will help people regain the ability to expand the rib cage.
Recovery and recommendations
A rib contusion is not as severe an injury as it appears and has a fairly quick recovery time. The bone should have healed in a period of no more than 6 weeks , however, it can be extended up to 8 weeks, depending on each patient.
The recommendations that patients can follow do not go beyond resting and taking the respective analgesics. However, some measures to reduce inflammation and pain in the area are helpful:
- Apply ice for 10 to 20 minutes where there is pain.
- Avoid smoking.
- Sleep in a semi-sitting position and do not sleep on the affected side.
- Do not perform activities that generate pain.
Rib contusion: a particular injury
Rib contusions are injuries that present with a clinic very similar to that of fractures. They usually have the same origin.
However, bruises are less severe injuries, since there is no complete breakdown of the bone, so they take less time to heal.
A rib contusion is an injury that should not be underestimated. The pain it triggers can lead to respiratory failure.
Therefore, it is best to go to the specialist when their presence is suspected. Only the professional will be able to give a correct diagnosis and indicate the appropriate treatment.