What indicates a potential broken rib on physical examination?

Localized tenderness over the rib cage, which may be present even without a fracture, can indicate a possible rib injury but is not definitive on its own. Crepitus, which refers to a grating sensation or sound during movement, occurs when fractured ends of bone rub against each other or between the rib and surrounding tissue. When this symptom is combined with localized tenderness over the rib cage, it provides stronger evidence of a broken rib.

In this context, the higher specificity of crepitus alongside tenderness highlights a more significant and probable injury. Difficulty breathing can certainly be associated with rib injuries due to pain or potential injury to the lungs, but it is not a direct indicator of a broken rib. Swelling in the chest area may suggest trauma or injury but is not specific to a rib fracture and could indicate other conditions or injuries as well. Therefore, the presence of both crepitus and localized tenderness closely correlates with the likelihood of a rib fracture during a physical examination.