• Patrick Hoffstetter, Christian Dornia, Stephan Schäfer, Merle Wagner, Lena M Dendl, Christian Stroszczynski, and Andreas G Schreyer.
• Radiology, Asklepios Medical Center, Bad Abbach, Germany ; Radiology, University Medical Center, Regensburg, Germany.
• J Trauma Manag Outcomes. 2014 Jan 1;8:10.

BackgroundRib series (RS) are a special radiological technique to improve the visualization of the bony parts of the chest.ObjectivesThe aim of this study was to evaluate the diagnostic accuracy of rib series in minor thorax trauma.MethodsRetrospective study of 56 patients who received RS, 39 patients where additionally evaluated by plain chest film (PCF). All patients underwent a computed tomography (CT) of the chest. RS and PCF were re-read independently by three radiologists, the results were compared with the CT as goldstandard. Sensitivity, specificity, negative and positive predictive value were calculated. Significance in the differences of findings was determined by McNemar test, interobserver variability by Cohens kappa test.Results56 patients were evaluated (34 men, 22 women, mean age =61 y.). In 22 patients one or more rib fracture could be identified by CT. In 18 of these cases (82%) the correct diagnosis was made by RS, in 16 cases (73%) the correct number of involved ribs was detected. These differences were significant (p = 0.03). Specificity was 100%, negative and positive predictive value were 85% and 100%. Kappa values for the interobserver agreement was 0.92-0.96. Sensitivity of PCF was 46% and was significantly lower (p = 0.008) compared to CT.ConclusionsRib series does not seem to be an useful examination in evaluating minor thorax trauma. CT seems to be the method of choice to detect rib fractures, but the clinical value of the radiological proof has to be discussed and investigated in larger follow up studies.

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