A patient with an isolated rib fracture or a minor costochondral separation usually has recently fallen, injuring the side of the chest; been struck by a blunt object; coughed violently; or leaned over a rigid edge. The initial chest pain may subside, but over the next few hours or days the pain increases with movement, interferes with sleep and activity, and becomes severe when the patient coughs or breathes deeply. The patient is often worried about having a broken rib and may have a sensation of bony crepitus or abnormal rib movement. Breath sounds bilaterally should be normal unless there is substantial splinting or a pneumothorax or hemothorax is present. There is point tenderness over the site of the injury, and occasionally bony crepitus can be felt.