Not radiographically recognisable (unless signficant cartilage calcification) these costal cartilage fractures can be easily missed. This is a case of a AFL footballer who reported severe left upper quadrant pain post collision.

The patient presented on Monday still in acute pain from a weekend injury with an x-ray showing no abnormality. On scanning we could easily identify a costal cartilage fracture with overlap of the chondral ends. Surrounding soft tissue swelling was also noted.

Interruptions to the costal cartilage or ribs are easily identified with ultrasound which is an excellent tool for assessing these areas.

Significant step noted in costal cartilage with surrounding soft tissue swelling.

Short axis view along costal cartilage.

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