Dr. Atul Prakash
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am in my late thirties, and recently I picked up something heavy and fell with it and got a blunt-force or twisting injury to my left ribs or costal region. There was a slight sharp pain at the moment of the injury. There is not much pain currently unless I bend in certain directions or cough hard. However, immediately after the injury, I noticed a slight indentation in the costal region below my left chest, and the lower ribs seemed pushed out a bit. The whole area does not look quite right. I consulted a doctor the same day of the injury and took X-rays. There are no fractures, and the doctor said not much could be done and prescribed anti-inflammatories and painkillers. The pain will probably eventually go away, but will this indentation in my ribs and the general "warping" caused by the injury get alright? Is there anything I can do to correct this? Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern.
Ribs are connected to the backbone and, in the front, to the breast bone called the sternum. The bone, held at two ends, is unlikely to fall out or warp. What you may be seeing as an indentation could be the muscle spasm causing the gap between the ribs to appear more prominent and is likely to settle down with drugs and rest, especially when the X-rays are normal. Perhaps you could send me a discreet picture showing the indentation from the front and the side so that I could make a visual impression.
Kindly revert for more queries.
Thank you.
Patient's Query
Thank you for your reply, doctor.
Please find the attached pictures. As you can see, the indentation below the chest is very clear in the pictures sent. All of this appeared as soon as the heavy object landed on me, and I twisted. As I said, there was a brief, sharp pain, which has subsided except when I lean or bend in certain directions, and now I have these indentations. What could this be? Will it heal back to normal? Will it come back to normal on its own? Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern. Even though the difference between the two sides is obvious in the images (attachment removed to protect the patient's identity), I do not see any bruising or other skin changes. Still, you have pain during a cough effort. Interestingly the region you have pointed out is along the costal margin where the ribs are continuous as cartilages rather than bone as they go around to meet the sternum in front. So, the plain chest X-ray will not pick up, as very little bone will show up on the X-ray. If you are having pain and the area is tender to touch on deep pressure and clinically there is asymmetry, I will suggest an MRI (magnetic resonance imaging). MRI is an ideal investigation as it will pick up any cartilage issues and edema in general, indicating a traumatic pathology. In the meantime, I would suggest rest, ice compression, and anti-inflammatory medicines for the symptoms.
I hope this helps.
Thank you.
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Orthopedician and Traumatology
Orthopedician and Traumatology
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