A Hidden Cause of Chest Pain in Adolescence: First Rib Fracture Without Trauma.

First rib fractures in adolescents are uncommon and typically result from high-impact trauma. However, they can also occur following low-energy mechanisms and may be easily overlooked in the absence of a clear traumatic event. We report the case of a 13-year-old boy with no prior medical history who presented with sudden-onset left-sided chest pain after pushing his bicycle while making a right turn. The physical examination revealed localized tenderness in the upper left chest, with no visible signs of trauma. A chest radiograph demonstrated a fracture of the left first rib. This case highlights the importance of considering first rib fractures in adolescents presenting with unexplained chest pain, even after seemingly benign activities. Prompt recognition and appropriate imaging can facilitate accurate diagnosis, avoid unnecessary testing, and alleviate anxiety for both patients and their families.