Cough-Induced Rib Fractures

Epidemiology and Presentation

• Cough-induced rib fractures are documented in approximately 82.4% of patients who present with post-tussive chest pain, with the 10th rib being the most frequently affected 1, 2
• Severe coughing fits can cause widening of rib spaces, with approximately 44% of patients developing associated rib fractures 1, 2

Mechanism and Risk Factors

• High-altitude exposure increases cough frequency and cough-receptor sensitivity 3
• Risk factors for cough-induced rib fractures include chronic respiratory conditions and smoking, which increase cough frequency and severity, although the exact prevalence is not specified 3

Diagnostic Considerations

• Radiographic rib series are more sensitive than standard chest radiographs for detecting cough-induced rib fractures 1, 2
• Chest CT should be reserved for patients who require evaluation of other pulmonary diseases 1, 2
• Point-of-care ultrasound has shown utility in detecting rib fractures in emergency settings, with 29% of cases showing rib fractures after negative chest radiography 1

Management Considerations

• Addressing the underlying cause of cough is essential to prevent recurrence 4