Chest Injury in 35-Year-Old Male Following Car Accident
Patient Profile: 35-year-old male, 6’1, weighing 240 lbs, non-smoker; suffering from hypertension, high cholesterol, and gastroesophageal reflux disease (GERD). Current medications include nortriptyline, omeprazole, atorvastatin, lisinopril, and tirzepatide. Background: In February, I experienced a car collision that resulted in my vehicle being totaled; all of the airbags deployed. After a couple of hours post-accident, I visited the emergency room where CT scans of my head and chest were performed with contrast, accompanied by basic cardiac evaluations. Initially, no injuries were detected. However, persistent chest pain over the following month prompted a second chest CT, revealing a non-displaced fracture of the sternum. My primary care physician advised me to refrain from lifting and certain activities until I could see a cardiothoracic specialist. The referral for the consultation took nearly a month. Upon evaluation, the cardiothoracic team decided against surgical intervention and directed me to pain management for a nerve block, extending my lifting and activity restrictions for another six weeks. It was another month before I could secure an appointment with pain management. There, I received a referral to a pain psychologist and was prescribed nortriptyline. I underwent a nerve block procedure at the end of May, and it took about a week for noticeable pain alleviation. Physical therapy commenced in mid-June, but progress toward regaining my pre-accident strength has been discouragingly slow. Additionally, under the direction of pain management, I received two PRP (platelet-rich plasma) injections—one at the end of June and another in late July. These injections resulted in bruising, tightness, and swelling that hindered my recovery process. Although I am continuing with physical therapy, gains in strength and stamina remain minimal. My physical therapist is contemplating a referral to an orthopedic specialist focusing on upper body injuries. Personal Impacts: I am a parent to two young children, and this injury has significantly limited my ability to engage with them as I used to. Routine yard work and similar activities have become tasks I now avoid to prevent exacerbating my condition. I have a history of various sports-related injuries and surgeries (including ankle, knee, shoulder, and nerve entrapment), yet none have resulted in such a protracted recovery. Inquiry: Given my lack of significant improvement, I am questioning whether additional diagnostic evaluations could be warranted. I am also curious if there are hidden complications from the blunt chest trauma that may have been overlooked. Are there specific specialists I should consider consulting for further evaluation? Thank you for any insights and guidance you can provide.
Answers (1)
7/31/2025, 10:40:50 PM
OpenHealth AI
It sounds like you have been through a challenging recovery process following your car accident, and I understand your concerns about your persistent chest pain and limited improvement. Given your situation, it is reasonable to explore additional evaluations for any potential complications from the blunt chest trauma.
Explanation
After a chest injury, even if initial scans show no significant damage, there can be lingering issues such as soft tissue injuries, cartilage damage, or other non-fracture complications that may not have been immediately apparent. Your ongoing pain and the slow progress in physical therapy, despite treatment efforts like nerve blocks and PRP injections, certainly warrant further investigation.
Next Steps
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Consult an Orthopedic Specialist: Since your physical therapist has already suggested a referral to an orthopedic specialist focusing on upper body injuries, this should be your priority. They can perform a detailed evaluation of any musculoskeletal injuries that might have been overlooked.
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Consider a Pulmonologist or Cardiologist: Given your history of chest trauma and ongoing pain, consulting a pulmonologist can help rule out any underlying lung issues (such as a pneumothorax, which can occur after a blunt chest injury). Alternatively, a cardiologist can evaluate your cardiac health, especially since you have a history of hypertension.
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Request Imaging Studies: When seeing these specialists, ask about the possibility of additional imaging studies, such as MRI or ultrasound, to assess soft tissues and structures that might not show up on a standard chest CT. This can help identify pain sources that are not evident on previous scans.
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Monitor and Record Symptoms: Keep detailed notes of your symptoms, including pain levels, activities that exacerbate or relieve pain, and any new symptoms you may experience. This information can help your healthcare providers make more informed decisions.
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Explore Pain Management Options: If you continue to have limited improvement and pain, discuss additional pain management strategies with your pain management team. This might include alternate therapies or adjustments to your current treatment regimen.
Final Note
It's understandable to feel frustrated with the slow pace of recovery, especially with young children who rely on you. Focus on the specialists and evaluations mentioned above to get a clearer picture of your recovery path and possibly expedite improvement. If you have any further questions or need additional support, feel free to reach out. Take care!
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