Furthermore, patients with known malignancy and benign rib fractures may exhibit false-positive findings on PET using the tracer fluorine- 18-2-fluoro-2-deoxy-D- glucose (FDG) studies performed 17 days to 8 weeks after injury [32]. Variant 2: Suspected rib fractures after cardiopulmonary resuscitation (CPR). Initial imaging. Radiography Chest Multiple studies [33-35] have shown that rib fractures are under-reported on radiography performed following cardiopulmonary resuscitation (CPR). In a retrospective analysis of 40 patients who survived CPR, Kim et al [33] reported that CT detected rib fractures in 26 patients (65%); whereas, anteroposterior chest radiography detected fractures in only 10 of the patients. Lederer et al [34] found that radiography detected only 14% of rib fractures compared to autopsy in 19 patients. Rib fractures from CPR are more commonly anterior, on the left side, and are more numerous in the elderly [34]. The diagnosis of such fractures in CPR survivors may be important since approximately half of CPR survivors with rib fractures experience complications, and the presence of rib fractures in these patients may impair Rib Fractures ventilation and compromise recovery. It should be noted that many of these patients are examined with portable supine radiography, which may contribute to underdiagnosis. Radiography Rib Views There is no strong indication in the literature that radiography rib series serves any significant use as an initial imaging modality to detect rib fractures after CPR. US Chest While focused US of the chest wall is more sensitive for detection of rib fractures than radiography in trauma patients [28], there is no direct evidence assessing the use of US in patients after CPR. Bone Scan Whole Body There is no strong indication in the literature that bone scan serves any significant use as an initial imaging modality to detect rib fractures after CPR.
Rib Fractures. Furthermore, patients with known malignancy and benign rib fractures may exhibit false-positive findings on PET using the tracer fluorine- 18-2-fluoro-2-deoxy-D- glucose (FDG) studies performed 17 days to 8 weeks after injury [32]. Variant 2: Suspected rib fractures after cardiopulmonary resuscitation (CPR). Initial imaging. Radiography Chest Multiple studies [33-35] have shown that rib fractures are under-reported on radiography performed following cardiopulmonary resuscitation (CPR). In a retrospective analysis of 40 patients who survived CPR, Kim et al [33] reported that CT detected rib fractures in 26 patients (65%); whereas, anteroposterior chest radiography detected fractures in only 10 of the patients. Lederer et al [34] found that radiography detected only 14% of rib fractures compared to autopsy in 19 patients. Rib fractures from CPR are more commonly anterior, on the left side, and are more numerous in the elderly [34]. The diagnosis of such fractures in CPR survivors may be important since approximately half of CPR survivors with rib fractures experience complications, and the presence of rib fractures in these patients may impair Rib Fractures ventilation and compromise recovery. It should be noted that many of these patients are examined with portable supine radiography, which may contribute to underdiagnosis. Radiography Rib Views There is no strong indication in the literature that radiography rib series serves any significant use as an initial imaging modality to detect rib fractures after CPR. US Chest While focused US of the chest wall is more sensitive for detection of rib fractures than radiography in trauma patients [28], there is no direct evidence assessing the use of US in patients after CPR. Bone Scan Whole Body There is no strong indication in the literature that bone scan serves any significant use as an initial imaging modality to detect rib fractures after CPR.