Delayed complication of a rib fracture.

A 48-year-old man who was kneed in the chest while playing basketball was diagnosed as having an occult rib fracture. Five days after the injury, he was taken to the emergency room with severe midsternal and left upper quadrant and pleuritic chest pain. Left-side chest radiographs and CT scans revealed a pleural effusion, compression atelectasis, and a minimally displaced fracture of the sixth rib. A tube thoracostomy was performed, the pleural cavity was drained, and the patient recovered. His case illustrates the need to be alert for serious complications in apparently ordinary sports-related rib fractures.