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-Feb;34(1):144-150. doi: 10.3122/jabfm.2021.01.200276.
Rib 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.
We 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.
One 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.
Single-view chest radiograph provides sufficient information for the clinical management of ambulatory patients with rib pain.
肋骨系列经常为抱怨肋骨疼痛或遭受胸部创伤的门诊患者开单。然而，肋骨系列在之前的研究中已经受到质疑。本研究的目的是比较肋骨系列与单张后前位胸部 X 线在大多数有肋骨疼痛的门诊患者的临床管理中的效果。
我们回顾了 2016 年 1 月 1 日至 2016 年 12 月 31 日期间进行的所有肋骨疼痛的肋骨系列检查，排除了疑似骨转移、胸部或肋骨畸形以及先前肋骨系列的随访研究患者。我们记录了 30 ± 7 天内的任何随访影像学和/或手术干预、骨折诊断以及与肋骨骨折相关的并发症。
在研究期间共进行了 1791 次肋骨系列检查。其中，65.2%（1168 次）的肋骨系列检查是因为在临床指征中报告的创伤（创伤队列）。34.8%（623 次）的肋骨系列检查是因为临床指征没有具体说明急性创伤（非创伤队列）。有 323 次（17.9%）肋骨系列检查结果为骨折诊断，95 次（5.3%）为可能骨折诊断。有 50 次（2.8%）胸腔积液、7 次（0.4%）气胸和 1 次（0.1%）血胸被发现。2 名患者，1 名来自创伤队列，1 名来自非创伤队列，在随访期间进行了后续干预。在这两种情况下，导致后续干预的发现都可以在前位胸部 X 线片上看到。
单张胸部 X 线片可提供足够的信息，用于有肋骨疼痛的门诊患者的临床管理。
