Chest X-Ray Misses Most Rib Fractures

Computed tomography (CT) is more sensitive than plain films for rib fractures, but by how much? To answer this question, investigators conducted a planned secondary analysis of two prospective cohort studies of blunt trauma patients enrolled in the National Emergency X-Radiography Utilization Study. The investigators also compared mortality between patients with first or second rib fractures and those with fractures of other ribs.

Of 8661 patients who had both a chest CT scan and a chest x-ray performed in the emergency department, 24% had rib fractures, and 66% of fractures were seen only on CT scan. Patients with first or second rib fractures had significantly higher mortality than those with other rib fractures (7% vs. 4%), and were signi…