DOI: 10.1373/clinchem.2009.135095


A 32-year-old, otherwise healthy man presented initially with right rib and sternal pain after lifting a heavy object. The patient also reported several rib fractures 1 year previously associated with coughing. On examination, the patient had bilateral rib tenderness. Chest x-ray revealed multiple healing fractures of the sixth, seventh, and eighth ribs. A bone scan demonstrated increased uptake in the sternum and bilaterally in the ribs.