name: Rib Dislocation 
also known as: Costochondral Dislocation; Rib Subluxation 
also see: Rib Fracture; Rib Sprain; Rib Strain 
description: Most ribs have two articulation points, one joint on the back at the spine where the ribs originate; they then rap around the chest and have a second articulation with the sternum, also called the breast bone or the chest bone. Some of the lower ribs originate from the spine but fuse with each other or a free floating overlying the liver and spleen areas. A subluxed rib is when the rib is slightly out of joint and a dislocation is when it is completely out of joint. Causes usually include a direct blow to the chest, although a severe twisting action can dislocate a rib. Risk is increased with contact sports, such as football, rugby, wrestling, hockey, boxing, taek won do, as well as motor vehicle and motor cycle accident, falls, accidental or deliberate blows to the chest, previous rib injury. 
signs & symptoms: Includes chest pain, especially pinpoint pain at the site of the subluxation or dislocation, pain with deep breathing, coughing, laughing or sneezing, as well as difficulty breathing, tenderness, swelling, a deformity that can be both seen or felt. 
diagnosis: Based on signs, symptoms, history and exam, as well as a chest x-ray and spine x-rays. 
treatment: Small degrees of subluxation often relocate on their own. Occasionally, a subluxation or a dislocation of a rib might require manipulation in order to re-align the rib into it's normal position. On rare occasion, surgery might be necessary in order to reduce the dislocation and to repair ligament injuries. Most rib dislocations are also treated with rest, ice, a lightly applied elastic wrap that splints the rib without compromising breathing, and medication for pain and swelling. 
prevention: Includes wearing appropriate protective gear, rib vest, conditioning, stretching, seatbelts. 
outcome: Most rib dislocations heal in 4-6 weeks. Complications of a rib dislocation can include lung contusion or injury, slow healing, recurrent dislocation, arthritis

skynetMD suggests the following:

if: If the person has sustained a chest injury and is having difficulty breathing, with shortness of breath, lightheadedness, disorientation, rapid heart rate, hunger for air, blue lips
go to: Go to the phone and dial 911.
if: If the person has a chest injury and might have a rib dislocation, such as chest pain, especially pinpoint pain at the site of the subluxation or dislocation, pain with deep breathing, coughing, laughing or sneezing, difficulty breathing, tenderness, swelling, a deformity that can be both seen or felt
go to: Go to the hospital.
if: If the person has a rib dislocation and is under the care of a doctor, they should also rest, ice the area for 2-3 days, then alternate ice with heat, wear an elastic wrap or a pre-made chest-rib binder (both need to be worn low below the breasts regardless of where the fracture is so as to splint the chest without decreasing breathing), force oneself to gently cough and deep breath periodically in order to expand the lungs, and
go to: Go to the pharmacy for an ice bag, heating pad, elastic wrap or a pre-made chest-rib binder (read the instructions), and for acetaminophen, aspirin (if older than 19 years), ibuprofen or naproxen.

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Last updated December 1, 2001


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