The point where your rib connects to this cartilage is known as your costochondral joint. Costochondral separation is an injury that occurs when one or more of your ribs separates from this cartilage.
This type of injury is also called a separated rib. Costal cartilage between your ribs and breastbone gives your rib cage more flexibility and the ability to expand when you breathe. A sudden impact to your rib cage can cause a tear in this costal cartilage where your ribs are attached.
Violent, twisting motions or an impact to one side of your body can potentially lead to a separated rib. This can happen due to:. Many people who are diagnosed with a separated rib also have one or more fractured ribs. If you also have a fractured rib, you may notice bruising on your rib cage and swelling around the injury.
A costochondral separation may also be called a rib dislocation. A dislocation is an injury to a joint that causes a bone to be displaced from its usual position. A medical professional will be able to determine if your injury needs further medical attention or if it can be treated with rest and pain medication.
Many types of rib injuries have similar symptoms. A chest MRI is often used to diagnosis a rib separation. CT scans or ultrasounds may also help your doctor differentiate a costochondral separation from a rib fracture.
However, your doctor may recommend an X-ray if they suspect you also have a broken rib. Separated ribs often heal by themselves within 2 to 3 months. If your injury is more serious, or if you also have one or more broken ribs, your doctor may recommend surgery. In some cases, rib separation can lead to a potentially life threatening condition called flail chest, which requires immediate medical attention. Flail chest occurs when you experience multiple adjacent rib fractures.
It can cause a section of your chest to become separated from the rest of your ribs. This can damage your internal organs and cause internal bleeding. A small bump on the posterior rib surface is the tubercle of the rib , which articulates with the facet located on the transverse process of the same numbered vertebra. The remainder of the rib is the body of the rib shaft. Just lateral to the tubercle is the angle of the rib , the point at which the rib has its greatest degree of curvature.
The angles of the ribs form the most posterior extent of the thoracic cage. In the anatomical position, the angles align with the medial border of the scapula. A shallow costal groove for the passage of blood vessels and a nerve is found along the inferior margin of each rib.
The bony ribs do not extend anteriorly completely around to the sternum. Instead, each rib ends in a costal cartilage. These cartilages are made of hyaline cartilage and can extend for several inches. Most ribs are then attached, either directly or indirectly, to the sternum via their costal cartilage see Figure.
The ribs are classified into three groups based on their relationship to the sternum. Ribs 1—7 are classified as true ribs vertebrosternal ribs. The costal cartilage from each of these ribs attaches directly to the sternum. Ribs 8—12 are called false ribs vertebrochondral ribs. The costal cartilages from these ribs do not attach directly to the sternum. For ribs 8—10, the costal cartilages are attached to the cartilage of the next higher rib.
Thus, the cartilage of rib 10 attaches to the cartilage of rib 9, rib 9 then attaches to rib 8, and rib 8 is attached to rib 7. The last two false ribs 11—12 are also called floating ribs vertebral ribs. These are short ribs that do not attach to the sternum at all. Instead, their small costal cartilages terminate within the musculature of the lateral abdominal wall. It is composed of 12 pairs of ribs with their costal cartilages and the sternum. The ribs are anchored posteriorly to the 12 thoracic vertebrae.
The sternum consists of the manubrium, body, and xiphoid process. The manubrium and body are joined at the sternal angle, which is also the site for attachment of the second ribs. Ribs are flattened, curved bones and are numbered 1— Posteriorly, the head of the rib articulates with the costal facets located on the bodies of thoracic vertebrae and the rib tubercle articulates with the facet located on the vertebral transverse process.
The angle of the ribs forms the most posterior portion of the thoracic cage. The costal groove in the inferior margin of each rib carries blood vessels and a nerve. Anteriorly, each rib ends in a costal cartilage. True ribs 1—7 attach directly to the sternum via their costal cartilage. The false ribs 8—12 either attach to the sternum indirectly or not at all. Ribs 8—10 have their costal cartilages attached to the cartilage of the next higher rib. Children are less likely to break ribs because their bones are relatively flexible.
Flail chest is a serious injury Flail chest is the most common serious injury to the ribs. It occurs when three or more ribs are broken in at least two places, front and back. This will only happen if there has been a great deal of blunt force. For example, the injured area of ribcage sinks in when the person inhales, instead of lifting outwards.
This reversal is caused by changes to air pressure in the ribcage as a result of injury. However, it is the accompanying injury to the lungs that usually causes complications, not the broken ribcage.
Risk of serious injury The ribs enclose vital organs such as the heart and lungs, so chest trauma can cause life-threatening injuries. These can include: Pneumothorax — collapsed lung due to changes in pressure within the chest. This could be caused by a broken rib tearing the lung or a puncture in the chest wall. Symptoms can include breathing difficulties, chest pain and coughing up blood.
Cardiac and associated blood vessel injury — for example, trauma to the blood vessel servicing the heart coronary artery or a tear in the main artery of the body aorta. Splenic rupture — the spleen is located on the left side of the abdomen. Its roles include filtering the blood to remove abnormal cells and the manufacture of some immune system cells including antibodies and lymphocytes.
Splenic rupture means the outer capsule has split and the spleen bleeds into the abdominal cavity. Diagnosis of rib injuries Rib injuries are diagnosed using a number of tests including: History of the injury where you explain to your doctor what hashappened Physical examination Chest x-ray. Treatment aims to relieve pain while the injury heals, which can take up to six weeks in the case of fracture , and 12 weeks or more if the rib has been torn from the cartilage.
Treatment for bruised ribs is the same as for fractured ribs, but with a shorter recovery time. Options include: Rest Prescription strength pain-killing drugs Non-steroidal anti-inflammatory drugs NSAIDs Avoiding activities that aggravate the injury, such as sport Icepacks — may help to reduce inflammation in the early stages Mechanical ventilation help with breathing — may be needed in cases of severe flail chest.
Since the ribs enclose vital organs, including the heart and lungs, chest trauma can cause life-threatening injuries such as a punctured lung or a ruptured aorta.
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