A Curious Case of Back Ache

Abstract

It is rare to find multiple, bilateral, spontaeneous rib fractures, with insufficient etiology, in a young adult female having primary complaints of backache. To the best of our knowledge, only one such case has been reported in literature. Though it is not very uncommon to find multiple rib fractures in patients with osteoporosis, Cushing’s syndrome, post menopausal women, patients on steroids or due to chronic cough. We found 10 rib fractures in an otherwise healthy young female with just a few weeks of cough and presenting with only back ache as the primary symptom. Most laboratory tests and imaging scans were normal except for the fractures (left 4th, 5th, 6th, 9th and 10th ribs and right 5th, 6th, 8th, 9th and 10th). She was treated conservatively with a rib belt, rest and medications. All fractures healed well at 1 year. Supplementary alendronate and calcium were given. We consider focal osteoporosis to be the cause for multiple rib fractures triggered due to cough.