# A Hidden Cause of Chest Pain in Adolescence: First Rib Fracture Without Trauma

## TL;DR

A 13-year-old boy experienced chest pain from a first rib fracture without obvious trauma, showing such injuries can occur from minor activities.

## Contribution

Highlights first rib fractures as a potential cause of unexplained chest pain in adolescents without a history of trauma.

## Key findings

- A first rib fracture was diagnosed in a 13-year-old after minor bicycle activity.
- Physical examination showed localized tenderness without visible trauma.
- Prompt imaging confirmed the fracture, emphasizing the need for careful evaluation of unexplained chest pain in adolescents.

## Abstract

First rib fractures in adolescents are uncommon and typically result from high-impact trauma. However, they can also occur following low-energy mechanisms and may be easily overlooked in the absence of a clear traumatic event. We report the case of a 13-year-old boy with no prior medical history who presented with sudden-onset left-sided chest pain after pushing his bicycle while making a right turn. The physical examination revealed localized tenderness in the upper left chest, with no visible signs of trauma. A chest radiograph demonstrated a fracture of the left first rib. This case highlights the importance of considering first rib fractures in adolescents presenting with unexplained chest pain, even after seemingly benign activities. Prompt recognition and appropriate imaging can facilitate accurate diagnosis, avoid unnecessary testing, and alleviate anxiety for both patients and their families.