Cough-Induced Rib Fractures in a Frequent Tea Drinker

Bruce M. Rothschild, MD


August 11, 2020

Physical Examination and Workup

A complete physical examination revealed minimal tenderness of the mid-thoracic spine to percussion and a normal range of spinal motion (flexion, extension, lateral bending). No kyphosis was obvious. The remainder of the physical examination was within normal limits except for the reduction of her previously measured height by 1 inch (2.54 cm). Her weight was unchanged at 90 lb (40.82 kg). Both measurements were compared with findings from previous clinical visits that were also taken in the early morning.

Overall, a general examination of all systems yielded no significant findings. No masses, rashes, lumps, or bumps were found. A musculoskeletal examination included evaluation for malalignment, asymmetry, crepitation, defects, tenderness, masses, effusion, range of motion, stability, and muscle tone. No abnormalities were found.

The workup revealed an erythrocyte sedimentation rate within the reference range. Her hemoglobin level was 15 g/dL, albumin level was 3.5 g/dL, and calcium level was 8.9 mg/dL. Chest radiography was performed (Figure 1).

Figure 1.

Bone density testing was scheduled but had not yet been performed by her follow-up visit.


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