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Pleural pain post rib fracture - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3339 Questions
User :   I have a tender, and sometimes painful hard knot (about 1/2 inch x 1 inch) on my right 4th rib located just under my breast tissue. The pain started with bronchitis, and I was diagnosed with a fractured rib. I do not have insurance, but am worried about this growth, as I am also 108 lbs (previously 122-125), and still have a cough (not severe anymore) after about 6 weeks.
Doctor :   hello
Doctor :   give me a min please, let me read your query
User :   Hi.
Doctor :   May i know your age and gender please
User :   Female, 36
Doctor :   when were you diagnosed with a fractured rib ?
User :   about 5 weeks ago, but the dr's first diagnosis was plureisy
Doctor :   what were the tests done
Doctor :   ?
User :   just an x-ray, I was also put on amoxil, steriod pack, and antihistamine, I changed my antibiotic to z-pak after a week of no difference in the cough
Doctor :   do you smoke ?
User :   NO!
User :   My mom did for the 19 years that I lived at home..
Doctor :   and when were your diagnosed with bronchitis ?
User :   a few days before the rib fracture..
User :   He didn't do a 2nd xray to diagnose the rib fracture.
Doctor :   was there a trauma ?>
User :   No, just a LOT of coughing.
Doctor :   yes, true severe coughing spells are a cause
Doctor :   anyway now to begin with . you still have the cough and tell me about the knot you have mentioned
Doctor :   when did you noticed that ?
User :   yes, that's my main concern-the is about 1/2 inch by 1 inch (the best I can feel) and is very hard, like it is attached to the bone. Since I am so skinny, it is easy to feel under the skin. It doesn't move at all and when pressed, or when I breath deep, or cough, it's painful. This is the same area where the severe pain was coming from 6 weeks ago.
User :   I noticed it the first time about 3 weeks ago.
Doctor :   ok
Doctor :   well i think from all the history you have told me that there could be a spurr formation at the site of the fracture
Doctor :   thats i causing this
User :   like a bone spurr?
Doctor :   yes
Doctor :   but i am also concerned about your weight loss
User :   yes, I am too. I have been losing weight for about 5 months now, but I eat like a horse
User :   I am a very busy person, and am always on the go...
Doctor :   well you do need a series of tests to be done . i will suggest a CT scan of chest is must
Doctor :   what all medications are you on at the moment ?>
User :   none
Doctor :   ok
Doctor :   a CT SCAN will give us a better picture as to what is going on with the knot ..
Doctor :   but it does sound very much like a overgrowth
User :   I do have some bone spurrs in my spinal vertebrae, is that common to have them in other areas?
Doctor :   there is a co relation
User :   Is that related to a vitamin D deficiency? Because last Nov. (when I had insurance) I was diagnosed with a deficiency and was put on 50,000 units weekly for 3 months, then 1000 per day, for 4 months.
User :   I am no longer taking vitamin D.
Doctor :   when you are having a vitamin deficiency the body tries to resorb the bone
User :   So that doesn't contribute to spurrs?
Doctor :   then as a counter mechanism the abnormal growth occurs
Doctor :   so yes it is a very possible cause
User :   ok, that makes sense
User :   maybe I need to get back on my vitamin D...
Doctor :   YES
Doctor :   you do and also you need to make sure you get your calcium levels tested
User :   Do you still think that a CT is necessary? And what do I do? I don't have insurance.
Doctor :   i am afraid yes it is. we need to know exact cause
Doctor :   when was your last X RAY done ?
User :   5weeks ago
Doctor :   ok well in that case you can get a X RAY and get it shown to a specialist
Doctor :   do you have your previous reports ?
User :   no reports were done, this was at a walk in clinic, and he didn't even charge me for the xray ( he looked at them himself)....
Doctor :   esp your X RAY
User :   If this was some kind of cancer, I would be much sicker, right? That's just my worry, because cancer runs in my family.
Doctor :   yes you would be
Doctor :   do get the tests done i have mentioned
Doctor :   you will be fine dont worry
User :   Do I just go back to the walk in clinic, or to an ER?
Doctor :   walk in clinic is ok
User :   Ok, thanks for your time. I appreciate your insight. I will definitely look into the "bone spurr" sugesstion.
Doctor :   Your welcome
Doctor :   take care
Doctor :   good bye
User :   Good bye :)
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