• Emily Nishimura, Alyssa Finger, Mark Harris, and Hyo-Chun Yoon.
• From Pomona College, Claremont, CA (EN); School of Medicine, Creighton University, Omaha, NE (AF); Brain and Spinal Injury Center, University of California, San Francisco, CA (MH); Hawaii Permanente Medical Group, Honolulu, HI (HCY).
• J Am Board Fam Med. 2021 Jan 1; 34 (1): 144-150.

IntroductionRib series are frequently ordered for ambulatory patients who complain of rib pain or have suffered chest trauma. However, the utility of rib series has been questioned in previous studies. The objective of this study was to compare the efficacy of rib series to a single view posteroanterior chest radiograph in the clinical management of most ambulatory patients with rib pain.MethodsWe reviewed all rib series for rib pain performed between January 1, 2016 and December 31, 2016, excluding patients with suspected bony metastasis, chest or rib deformities, and follow-up studies for prior rib series. We recorded any follow-up imaging and/or surgical intervention within 30 ± 7 days, fracture diagnosis, and complications relating to rib fractures.ResultsOne thousand seven hundred ninety-one rib series were performed during the study period. Of these, 1168 (65.2%) rib series were performed because of trauma as reported in the clinical indication (trauma cohort). Six hundred twenty-three (34.8%) of the rib series were performed for clinical indications which did not specify acute trauma (nontrauma cohort). There were 323 (17.9%) rib series that resulted in a fracture diagnosis and 95 (5.3%) that resulted in a possible fracture diagnosis. There were 50 (2.8%) effusions, 7 (0.4%), pneumothoraces, and 1 (0.1%) hemothorax detected. Two patients, 1 each from the trauma and nontrauma cohorts, underwent subsequent intervention during the follow-up period. In both cases, the findings which led to the subsequent intervention could be seen on the initial posteroanterior chest radiograph.ConclusionSingle-view chest radiograph provides sufficient information for the clinical management of ambulatory patients with rib pain.© Copyright 2021 by the American Board of Family Medicine.

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