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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #6

Have a patient with rib pain or a rib injury? Can’t decide if you want to do an x-ray or not? Perform the “squeeze test.” All you do is place one hand on the anterior chest and the other hand on the posterior chest and squeeze 3-4 times back to back in a fast squishing motion. If this exacerbates the pain, you better do an x-ray. If it does not illicit pain, you can treat them symptomatically with NSAID’s or a short course of prednisone.

I have never had a positive rib fracture with a negative squeeze test. I have had plenty of negative x-rays and positive squeeze tests on the other hand. If you think about it, it makes sense: If a rib was fractured and you squeezed over that particular rib at the proximal and distal ends, it would elicit pain. This is not always the case with a soft tissue injury to the chest wall though.

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