Usefulness of ultrasonography for first rib stress fracture: A case report

Abstract

Stress fractures of the first rib are relatively rare in athletes. The author describes the case of a 17-year-old man, elite baseball player, who had pain in the right posterior shoulder. Ultrasound image revealed a discontinuity of the cortex and echo-free spaces on the bone surface. The distance between the first rib and the subclavian artery was significantly increased compared to the healthy side. Plain radiography of the right first rib revealed a stress fracture of the first rib. Following conservative treatment with rest from baseball activities and physical therapy, the patient returned to baseball with complete fracture healing. Ultrasonography successfully visualized the fracture of the first rib. Early diagnosis and appropriate conservative treatment with physical therapy are essential for successful clinical outcome and early return to sport.