Ultrasound superiority in detecting micro rib lesions for post-coronavirus disease 2019 chest wall pain: a comparative retrospective study.

Background: Post-coronavirus disease 2019 (COVID-19) patients often experience persistent chest wall pain, highlighting the need for effective diagnostic imaging. This study aims to compare the effectiveness of ultrasound (US) and computed tomography (CT) in detecting chest wall lesions in patients with post-COVID-19 chest pain. Methods: We conducted a retrospective observational study of patients experiencing sudden chest wall pain with a fixed position following COVID-19 at a tertiary hospital from December 1 to December 31, 2022. Patients underwent US and/or CT examinations and were classified into positive and negative groups based on the US and CT results. We compared data on chest pain duration, cough severity [assessed by Visual Analog Scale (VAS)], chest pain severity (assessed by VAS), and pain relief between the two groups. Results: A total of 47 patients participated in the study: 25 in the positive group and 22 in the negative group. No significant differences were found in the duration of COVID-19 or chest pain (P=0.58 and P=0.71). However, the VAS scores for pain and cough severity were significantly higher in the positive group (P<0.01). At the follow-up visit, 3-4 weeks later, the positive group also showed greater pain relief (P<0.01). All 25 patients in the positive group had positive ultrasonography results, with rib changes in 17, primarily non-displaced fractures in 12. Only 5 patients (20%) in this group had positive CT results, all indicating rib lesions. Conclusions: Chest wall pain in post-COVID-19 patients with a cough may stem from various factors, primarily rib lesions. US is more effective than CT scans for detecting these lesions and provides a safe, portable, high-resolution monitoring method.