Case Report  |   March 2018
Nontraumatic First Rib Fracture and Empyema Presenting as Shoulder Pain
Author Notes
  • From the UnityPoint Clinic in Grundy Center, Iowa (Dr Neverman), and the University of Missouri School of Medicine in Columbia (Dr Clary). 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Eric M. Neverman, DO, MHA, UnityPoint Clinic, 101 East J Ave, Suite 120, Grundy Center, IA 50638-2006. Email: eric.neverman@unitypoint.org
     
Article Information
Emergency Medicine / Pain Management/Palliative Care
Case Report   |   March 2018
Nontraumatic First Rib Fracture and Empyema Presenting as Shoulder Pain
The Journal of the American Osteopathic Association, March 2018, Vol. 118, e12-e14. doi:10.7556/jaoa.2018.040
The Journal of the American Osteopathic Association, March 2018, Vol. 118, e12-e14. doi:10.7556/jaoa.2018.040
Abstract

Fracture of the first rib is rare because of the anatomic protection provided by surrounding structures. Osseous fatigue caused by repetitive motion and antagonistic muscular contraction is postulated to contribute to nontraumatic first rib fracture, which is most often described in adolescent athletes in sports that involve repetitive overhead motion of the arm. In this report, we describe a 49-year-old man with an occupation involving repetitive overhead motion at the shoulder who was found to have a nontraumatic first rib fracture. The condition resolved with treatment.

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