Rib fracture: trace the cortex

Question 1Where do you start the scan for a suspected rib fracture?

1. aAt the point of maximal tenderness, along the long axis of the rib
2. bOver the sternum only
3. cOver the scapula
4. dIn the axilla regardless of symptoms

Question 2What does a rib fracture look like on ultrasound?

1. aA black line with no shadow
2. bComet tails from the pleura
3. cA smooth continuous cortex
4. dA step, gap or break in the bright cortical line

Question 3Why can ultrasound find fractures an X-ray misses?

1. aIt is always more accurate everywhere
2. bIt sees through the bone
3. cIt scans exactly where it hurts, including the costal cartilage
4. dIt uses more radiation

Question 4After finding a rib fracture, what else should you look for?

1. aLung sliding and fluid above the diaphragm
2. bThe gallbladder
3. cThe optic nerve
4. dUreteric jets

Question 5Which patients with rib fractures need the most caution?

1. aAnyone with a normal scan
2. bOlder patients and those with several fractures, lung disease or anticoagulation
3. cPatients who can cough freely
4. dYoung athletes with one fracture