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Stress Fractures of the Ribs and Upper Extremities: Causation, Evaluation, and Management

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Abstract

Stress fractures are common troublesome injuries in athletes and non-athletes. Historically, stress fractures have been thought to predominate in the lower extremities secondary to the repetitive stresses of impact loading. Stress injuries of the ribs and upper extremities are much less common and often unrecognized. Consequently, these injuries are often omitted from the differential diagnosis of rib or upper extremity pain. Given the infrequency of this diagnosis, few case reports or case series have reported on their precipitating activities and common locations. Appropriate evaluation for these injuries requires a thorough history and physical examination. Radiographs may be negative early, requiring bone scintigraphy or MRI to confirm the diagnosis. Nonoperative and operative treatment recommendations are made based on location, injury classification, and causative activity. An understanding of the most common locations of upper extremity stress fractures and their associated causative activities is essential for prompt diagnosis and optimal treatment.

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Acknowledgments

No funding was received to support the preparation of this article. The authors have no conflicts of interest to report.

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Authors and Affiliations

  1. OSU Sports Medicine, 2050 Kenny Road, Suite 3100, Columbus, OH, 43221, USA

    Timothy L. Miller

  2. Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL, USA

    Joshua D. Harris

  3. Judson Wilson Professor Department of Orthopaedics, OSU Sports Medicine, The Ohio State University, Columbus, OH, USA

    Christopher C. Kaeding

  4. Care Point Lewis Center, 6515 Pullman Drive, Suite 1100, Lewis Center, OH, 43035, USA

    Timothy L. Miller

Authors
  1. Timothy L. Miller
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  2. Joshua D. Harris
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  3. Christopher C. Kaeding
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Correspondence to Timothy L. Miller.

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Miller, T.L., Harris, J.D. & Kaeding, C.C. Stress Fractures of the Ribs and Upper Extremities: Causation, Evaluation, and Management. Sports Med 43, 665–674 (2013). https://doi.org/10.1007/s40279-013-0048-7

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