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What are the symptoms of rib fracture?

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Posted on Thu, 13 Nov 2014
Question: hi, My name is XXXX and i am after a medical opinion on a topic regarding OI type 1 and/or TBBD.

my question is when a rib is fracture is there symptoms, if multiple ribs are fractures is there pain, if their is multiple rib fractures at different stages say two weeks from each break is it painful?

what forces would cause multiple ribs to break? will there be any physical signs at one point if multiple ribs are being broken and its occurring with a fortnightly appearance.

Now if i was to tell you of a patient who has suffered from multiple rib fractures at different times (different stages of healing, 2weeks or so apart) with no pain what so ever, no swelling nothing. It has gone unnoticed by 3 medical professionals and was only picked up with a xray done for another reason what would be your first thoughts, consider this person to also have excessive sweating and a very hot body (rashes quite easily, cant regulate his or hers temperature) and bruises easily however no bruises on the fractured sites at any occurrence. My first thought was OI-Osteogenesis imperfecta type 1 (mild)
http://www.oif.org/site/DocServer/_Child_Abuse__Child_Abuse_or_Ostegenesis_Imperfecta.pdf?docID=7189
http://www.oif.org/site/PageServer?pagename=TypeI

my second thought would be
temporary brittle bone disease
http://www.ncbi.nlm.nih.gov/pubmed/0000.

now you might be wondering why i am asking these questions and with an idea of what it might be, the reason for this is i am a young Mother to a 3month old baby, i had gone to the doctor with my concerns of bruising that would just appear from routine things like a hip check or when the doctor had checked to see if the baby had thrush. i had also notice he would always sweat even in the cold months and would rash up so easily (you wouldnt know what to dress him in most days). well that resulted in my Husband and i being accused of child abuse and my son taken away. Following that they did all the test they normally do at CPS and found out he had multiple rib fractures (posterior) at different stages of healing, now i know none of us nor his grandparents have harmed him, what i cannot believe is how 3 medical professionals have messed something so serious. I have done many hours of research and spoken to 3 GPs and a nurse all have which thought the same thing, something needs to be medical wrong for a 2month old at the time not to feel serveral bones break. No fever no tenderness no swelling nothing, i have also done a lot of research and for his bones to break the way they are saying it was done he would of had to at one point have external and internal injuries. i also know the test they are doing doesnt pick up OI type 1 or TBBD and i know they will not do any further scans or testing to rule it out, they simply want someone to say they have hurt him which isnt the case, i had known from the start something was odd with my son with his sweating/heat and as soon as i saw he was bruising easily i got help to just be accused of such a horrific crime, please can you give me medical advice and opinion or know another doctor who can that i can email?
doctor
Answered by Dr. Deepak Kishore Kaltari (50 minutes later)
Brief Answer:
It could be TBBD

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Ms,

Being a parent myself , I understand your concern and apprehension.

Its quite natural and logical for them to suspect Child abuse especially in 3 months old baby(who can't react appropriately to injury) with multiple posterior rib fracture especially in various stage of healing. I am a Paediatric Surgeon , I would also have suspected the same.
Not many would be aware of Temporary Brittle bone disease(TBBD). Its quite natural for doctors to be biased by findings alone and label it as child abuse.

The only way out in this scenario would to collect this references and approach the Physicians. It is difficult convincing them , But is quite possible. The circumstantial evidence and the statement of parents and grandparents would be helpful in convincing the doctors. Though a difficult job, with due patience and persistence can be achieved.


Do get back to me if you need any further assistance, will be glad to assist you.

Take Care

Best Regards
Dr Deepak Kaltari
Consultant Paediatric Surgeon
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Deepak Kishore Kaltari (15 minutes later)
its just so hard to even live without my son when i know i have not done anything nor my husband, i have given them numerous research papers and spoken to numerous people to make sure the information i am giving is correct. I simple cannot believe this is happening to be honest, XXXXXXX is such a happy healthy baby, the pediatrician who made the report himself said "we will do monthly visit to keep them happy" "nothing will come from this report i am just doing it for i have to" himself didnt even think our son was abuse, the midwife who i told about the first bruising i saw didnt, the GP who we took XXXXXXX to numerous times didnt. I have done numerous research and i know babies who are abuse like this lack in colour, weight and milestones for to drink much is painful, breathing is painful, when trauma happens to the chest not only are the bones affected but the muscle and skin tissue, the midwife and GP and pediatrician had seen XXXXXXX without clothes, felt him all over, listen to his chest and all, he has never made it clear at all that it was sore, no swelling, no redness, no bruising and he was breathing normally. I have also done numerous statistical research and to do those injuries via trauma that many times would cause such things as bruising and internal injuries to the organs protected by the ribs. My son now has gotten a UTI and high PH level (7) in care and trust me when i say this but when peeing or out of the blue he has shown his pain and that is from a UTI, that is how i know he can show pain, he also has shown pain when getting his needles, there is no doubt if he is in pain he doesnt like people know. However when he was home he would only cry when he was hungry or wanted me, as soon as you gave his bottle he would stop or as soon as he saw me reaching for him he would stop. there are numerous papers on the internet in medical vlogs that yes child abuse is a terrible thing but so is over diagnosing children with child abuse when in fact its TBBD or Mild OI type 1
doctor
Answered by Dr. Deepak Kishore Kaltari (4 hours later)
Brief Answer:
I totally agree with you

Detailed Answer:
Hi

I do agree with all the information collected by you. i would have been convinced by your explanations had I been your Paediatrician. Even a newborn can appreciate pain and do respond unfavourably to it by alteration in vital signs. Its very unlikely to be child abuse when there is no brushing or internal injuries in the presence of multiple segmental posterior rib fractures.
The bones of babies are highly resilient and require tremendous force to fracture them, in the use of such force there is high possibility of injury to internal organs. I totally accept your stand.

I would suggest you to take up this matter with panel of doctors where you can put forth your view.


God bless you.

Wishing you success

Regards
Deepak
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Deepak Kishore Kaltari (2 hours later)
i wish the doctors at CPS werent so bias and actually use their brains, if a mother can do the research and no what they are saying is impossible then surely they wont go out of their ways to ruin a family. Everyone is behind us, local GPs, midwife, parents(both sides) aunts, uncles everyone, everyone knows how much dessy is to us and its just so frustrating how they can say something like this yet nothing makes sense, since we know he bruises thats why i got him check out so not to bruise from such a horrific trauma like they are saying does not make sense! and for no internal injuries seriously! once this is all over i am going to make sure no other family goes through this when it is not needed, they need to not always assume but help families who sort help and knew something wasnt right, however they just put the blame back on them.


Also Dessy is 3months old has a UTI and a high PH level of 7, they are trying to say we cause it and hes had it before care (5weeks ago) now we are parents who record everything so we know for a fact his wees were good and good amounts and i know from experience that a UTI doesnt last that long if you are drinking so much, they are trying to blame us for everything when they should be helping my baby something isnt right? he has these fractures without trauma and pain, now he has a UTI like help my baby dont try to blame innocent parents
doctor
Answered by Dr. Deepak Kishore Kaltari (6 hours later)
Brief Answer:
My sympathy is with you

Detailed Answer:
Dear Ms

You are absolutely right and my sympathy is with you.

Afebrile UTI(absence of fever ) is less likely in 3 month old male baby. If there is no external genital Injury then its unlikely that UTI is result of child abuse.

What is Urine report? Was Ultrasound abdomen done to know the status of Kidney Ureter and bladder? Also possibility of Posterior Urethral valve needs to be ruled out as cause of UTI in male baby.

Awaiting your response


Take Care

Regards
Deepak
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Deepak Kishore Kaltari (7 hours later)
all i know is he had traces of blood in his urine, hes in pain, hes slightly feverish, his PH levels were 7. They are doing an ultra sound after a 7 day course of antibiotics.
doctor
Answered by Dr. Deepak Kishore Kaltari (11 hours later)
Brief Answer:
Details of scan required

Detailed Answer:
Dear Ms
Further assessment and cause of Urinary tract infection can only be attributed by Ultrasound scan. .
Do get back to me with details of reports


Take care

Best regards
Deepak
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3193 Questions

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What are the symptoms of rib fracture?

Brief Answer: It could be TBBD Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Dear Ms, Being a parent myself , I understand your concern and apprehension. Its quite natural and logical for them to suspect Child abuse especially in 3 months old baby(who can't react appropriately to injury) with multiple posterior rib fracture especially in various stage of healing. I am a Paediatric Surgeon , I would also have suspected the same. Not many would be aware of Temporary Brittle bone disease(TBBD). Its quite natural for doctors to be biased by findings alone and label it as child abuse. The only way out in this scenario would to collect this references and approach the Physicians. It is difficult convincing them , But is quite possible. The circumstantial evidence and the statement of parents and grandparents would be helpful in convincing the doctors. Though a difficult job, with due patience and persistence can be achieved. Do get back to me if you need any further assistance, will be glad to assist you. Take Care Best Regards Dr Deepak Kaltari Consultant Paediatric Surgeon