Traumatic Rib Fracture
I saw a lady in the Pain Clinic who had pain emanating from an old fracture of the right rib at the level of T5/T6. She had significant pain on the right side of her chest which occurred when she fractured the rib after the barrier doors of a train caught her.
On examination she was particularly tender over the old fracture of the rib right T5/6 area. She also had an increase in sensation to light touch (allodynia) and to pin prick sensation (hyperalgesia).
Diagnosis of intercostal neuralgia
Initially, this lady was given a diagnosis of intercostal neuralgia. She underwent a total 4 of intercostal nerve blocks, using long acting anaesthetic and the anti-inflammatory Depo-Medrone. She made a good recovery from this, stopped taking other analgesic medication and was discharged from the clinic.