Marco Scarci - Expert Thoracic Surgeon in London
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Chest Wall Pain · Rib Pain · Chest Wall Specialist · London

Sharp chest pain — but your heart is fine.
So what's actually going on?

Most chest and rib pain is not cardiac. It comes from the chest wall — the ribs, cartilage, nerves, and muscles that make up the structure of your chest. Finding the right diagnosis matters because the right treatment is completely different depending on the cause.

Book a Specialist Consultation → ic baseline phone 020 7459 4367
Mr Marco Scarci — Consultant Thoracic Surgeon London
Mr Marco Scarci FRCS · FCCP · FACS · FEBTS
Most Chest pain is musculoskeletal, not cardiac
10+ Distinct causes of chest wall pain
20+ Years' chest wall experience
<7 days Typically seen within one week
Heart ruled out — still in pain Clicking or popping sensation Sharp pain on breathing or movement Pain that radiates to back or abdomen Tenderness when pressing the ribs No clear diagnosis after weeks of tests
FRCS(Eng) · FCCP · FACS · FEBTS
Private chest wall specialist, London
All major insurers accepted
100+ five-star patient reviews
For anyone living with chest or rib pain that hasn't been explained

Being told "your heart is fine" is reassuring — but it doesn't explain why you're still in pain.

You went to A&E, or your GP, or perhaps directly to a cardiologist. An ECG was done. Blood tests. Maybe a chest X-ray. All normal. And you were told, correctly, that your heart isn't the problem. That's good news — but it left you with an unanswered question: then what is causing this?

The answer is almost always in the chest wall itself — the complex framework of ribs, cartilage, muscles, ligaments, and nerves that surrounds your heart and lungs. When something goes wrong here, it can produce pain that is every bit as sharp, severe, and frightening as cardiac pain. And it is frequently misdiagnosed, undertreated, or simply dismissed once the heart has been cleared.

"The chest wall is one of the most anatomically complex regions in the body — and one of the most commonly overlooked sources of chronic pain. Most patients I see with chest and rib pain have already had their heart investigated. What they haven't had is a proper chest wall examination. That's usually where the answer is."

This page explains the most common causes of chest and rib pain, how each is diagnosed, what treatment looks like, and — critically — when chest pain is a genuine emergency that cannot wait.

This guide covers: Sharp chest pain not cardiac Musculoskeletal chest pain London Costochondritis treatment London Chest wall pain specialist private Unexplained rib pain diagnosis Intercostal neuralgia treatment Chest pain when breathing / on movement Tietze syndrome treatment Rib cartilage pain / costal cartilage Chest wall pain after normal ECG

Book a Chest Wall Consultation

Seen within days. No referral needed. Mr Scarci specialises in chest wall pain — bring any existing scans, reports, or ECG results.

ic baseline phone Call 020 7459 4367
Seen within one week
All major insurers accepted
Bring existing scans & results
No GP referral required
→ Book online ✉ [email protected]

🚨 Seek emergency care immediately if:

Crushing, squeezing, or pressure chest pain
Pain radiating to jaw, arm, or back
Sudden breathlessness at rest
Collapse, dizziness, or sweating with chest pain
Coughing up blood

Call 999 — do not wait for a GP appointment

Which patients come to this page?

Does this sound like your experience?

Chest and rib pain presents in many different ways. These are the most common patterns that bring patients to a chest wall specialist.

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Heart ruled out — pain persists

Cardiac investigations came back normal but you're still experiencing sharp or aching chest pain. You're relieved it isn't the heart, but frustrated and confused about what is actually causing it.

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Pain that worsens when you breathe deeply

Taking a full breath, coughing, or sneezing triggers or dramatically worsens your chest or rib pain. You may be unconsciously breathing more shallowly to avoid triggering it.

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Specific tenderness when you press the ribs

There's a clear, reproducible spot of tenderness on the chest wall — pressing it triggers the pain. This pattern of localised tenderness often points to a specific, diagnosable cause.

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Clicking, popping, or instability in the ribs

You can feel — or even hear — something moving in your lower ribs when you bend or twist. The sensation of instability or "something shifting" is highly characteristic of certain chest wall conditions.

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Pain that radiates to the back or abdomen

Your chest pain doesn't stay in one place — it radiates around your side, into your back, or down into the upper abdomen. This pattern of referred pain has confused both you and your previous doctors.

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Ongoing pain with no clear diagnosis

Weeks or months of chest and rib pain, multiple appointments, investigations that came back normal, and still no diagnosis. You know something is wrong, but haven't yet found someone who can name it.

One of these describes your situation? A specialist chest wall consultation can provide the diagnosis that standard cardiac or respiratory investigations have not.
Book a Consultation →
What patients say
★★★★★

"I spent eight months convinced something was seriously wrong with my heart, despite four normal ECGs. Every time I went to A&E, they sent me home. Mr Scarci examined my chest properly for the first time in fifteen minutes — pressed on the specific spot and reproduced the pain immediately. Costochondritis, with a cortisone injection the same week. The relief was immediate."

Private patient, London — verified review
Understanding the structure

Why the chest wall is such a common source of pain

A framework that never stops moving

Your chest wall is not a static structure. It moves — expanding and contracting — with every single breath you take, around 20,000 times each day. It is made up of 12 pairs of ribs, the sternum, costal cartilage connecting the ribs to the breastbone, intercostal muscles between each rib, and an intricate network of nerves running along the underside of each rib.

Any of these structures — bone, cartilage, muscle, or nerve — can become a source of pain. Because they are all interconnected and constantly in motion, pain from one structure easily refers to another. A problem at the front of the chest can radiate to the back; a problem in the lower ribs can feel like abdominal pain.

This is why chest wall pain is so often misattributed — to the heart, to the stomach, to "stress" — and why a proper physical examination by someone who understands these structures is so important.

Any of these structures — bone, cartilage, muscle, or nerve — can be a source of chest wall pain
Chest wall anatomy — ribs, sternum, costal cartilage
The most common causes

Chest and rib pain — condition by condition

Here is a clear, plain-language breakdown of the most common conditions causing chest and rib pain — and what distinguishes each one.

🏥 Musculoskeletal & Cartilage Conditions
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Very common

Costochondritis

Inflammation of the costal cartilage — the connective tissue linking the ribs to the sternum. Causes sharp, reproducible chest pain that worsens with deep breathing, coughing, or pressing on the affected area. Most common in the upper ribs (2nd–5th). Often mistaken for a heart attack in A&E. Usually self-limiting but can be chronic and debilitating.

Diagnosis: Clinical — reproducible tenderness at costochondral joint
Treatment: Anti-inflammatories, rest, physiotherapy, steroid injections
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Less common

Tietze Syndrome

Similar to costochondritis but with a key difference: visible and palpable swelling at the costochondral junction. This localised, tender swelling distinguishes it from costochondritis on examination. Usually affects a single joint, most often the second or third. More common in younger adults.

Diagnosis: Clinical + ultrasound (visible swelling confirms it)
Treatment: NSAIDs, ice/heat, physiotherapy, local injection
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Common

Intercostal Muscle Strain

A pulled or torn intercostal muscle — the muscles between the ribs. Very common after sudden twisting movements, heavy lifting, or vigorous coughing. Produces sharp, localised pain that worsens with specific movements, breathing, or pressing the area. Distinguished from rib fractures by the absence of point tenderness directly on the bone.

Diagnosis: Clinical — localised but diffuse tenderness
Treatment: Rest, ice then heat, NSAIDs, graduated physiotherapy
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Underdiagnosed

Slipping Rib Syndrome (Cyriax Syndrome)

Hypermobility of the 8th–10th ribs, causing them to slip and irritate intercostal nerves. Sharp, stabbing lower rib pain that often clicks or pops and worsens with specific movements. Frequently misdiagnosed as gallbladder disease or IBS. The Hooking Maneuver is diagnostic. Standard imaging is normal.

Diagnosis: Hooking Maneuver + dynamic ultrasound
Treatment: Physiotherapy, nerve blocks, costal cartilage resection surgery
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Common after injury

Rib Fractures & Bruised Ribs

After a fall, accident, or even severe coughing. Sharp, point-specific tenderness directly on the rib bone. Pain worsens dramatically with deep breathing, coughing, or movement. Multiple rib fractures require specialist review to prevent pneumonia. X-rays can miss up to 50% of rib fractures — a CT scan is more reliable.

Diagnosis: CT scan (more sensitive than X-ray)
Treatment: Pain management, breathing exercises; surgery for complex cases
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Post-surgical / trauma

Rib Nonunion & Malunion

A previous rib fracture that has healed incorrectly (malunion) or failed to heal at all (nonunion). Causes persistent or worsening chest wall pain months after the original injury. Visible or palpable deformity may be present. Often requires surgical correction if causing significant functional impairment.

Diagnosis: CT scan with 3D reconstruction
Treatment: Surgical rib plating (ORIF) in appropriate cases
⚡ Nerve-Related Chest Pain
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Nerve

Intercostal Neuralgia

Irritation or compression of an intercostal nerve — the nerve running beneath each rib. Produces sharp, shooting, burning, or electric-shock pain that follows the path of the nerve, typically wrapping from the back around to the front. Can be caused by rib fractures, inflammation, post-herpetic scarring, or be idiopathic. Often worse at rest and at night.

Diagnosis: Clinical pattern + response to diagnostic nerve block
Treatment: Nerve block, anticonvulsants, TENS, physiotherapy
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Nerve — acute

Shingles (Herpes Zoster)

Before the characteristic rash appears, shingles causes severe burning or stabbing chest pain that follows a dermatomal pattern. Patients — and doctors — often miss the diagnosis in the pre-rash "prodromal" phase. The pain can be incapacitating. Post-herpetic neuralgia (pain persisting after the rash clears) can become chronic.

Diagnosis: Clinical (rash when present); consider if dermatomal distribution
Treatment: Antivirals (early); pain management for post-herpetic neuralgia
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Post-surgical

Post-Thoracotomy / Post-Surgical Pain

Persistent chest and rib pain after thoracic surgery caused by intercostal nerve injury or scar tissue formation. Affects a significant proportion of patients after thoracic surgery. Treatment requires specialist pain management — general practitioners often have limited experience with this specific presentation.

Diagnosis: Clinical history + response to nerve block
Treatment: Specialised pain clinic; nerve blocks; neuromodulation
⚕️ Conditions Requiring Urgent or Specialist Assessment
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Urgent

Pleuritis / Pleurisy

Inflammation of the pleura causes sharp chest pain that is dramatically worse on inspiration. Often accompanied by a friction rub heard with a stethoscope. Can result from infection, autoimmune disease, pulmonary embolism, or malignancy. Requires urgent investigation to identify the cause.

Diagnosis: Chest X-ray, CT, blood tests, pleural fluid analysis
Treatment: Directed at underlying cause; anti-inflammatories
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Specialist

Chest Wall Tumours

Primary tumours of the chest wall (sarcoma, chondrosarcoma) or secondary spread from other cancers can cause localised bone pain, a palpable lump, or progressive worsening pain. Relatively rare but should not be dismissed in anyone with persistent, unexplained, progressive chest wall pain — especially over a specific bony point.

Diagnosis: CT / MRI / bone scan / biopsy
Treatment: Surgical resection ± radiotherapy ± chemotherapy
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Emergency

Pulmonary Embolism (Clot on the Lung)

A blood clot in the pulmonary artery can cause sharp, pleuritic chest pain (worse on breathing), breathlessness, rapid heart rate, and sometimes coughing up blood. This is a medical emergency — not a musculoskeletal problem.

Diagnosis: CT pulmonary angiogram (CTPA) — emergency investigation
🚨 Seek emergency care immediately if PE is suspected

🚨 When chest pain is an emergency — do not wait

Musculoskeletal chest pain, however uncomfortable, is not life-threatening. But certain symptoms require immediate emergency attention. Call 999 or go directly to A&E if you experience any of the following:

If in doubt — go. The investigations that rule out the serious causes are done in hospital, not in a GP surgery or private clinic. Musculoskeletal causes can always be assessed once the dangerous ones have been excluded.
Sudden, crushing chest pain — especially radiating to the jaw, left arm, or between the shoulder blades
Severe breathlessness that develops rapidly at rest
Chest pain with sweating, nausea, or a feeling of impending doom
Coughing up blood or blood-stained sputum
Lips or fingertips turning blue (cyanosis)
Chest pain with a racing or very irregular heart rate
Sudden severe chest pain in the context of a recent long flight, surgery, or period of immobility (consider PE)
Collapse or loss of consciousness with chest pain

What might be causing your specific pain?

Different patterns of chest and rib pain point strongly toward different diagnoses. Click any symptom to see what it most likely indicates.

→ Likely costochondritis or Tietze syndrome Reproducible tenderness at the costochondral joint is the defining feature. A specialist can confirm within minutes of examination.
→ Likely slipping rib syndrome (Cyriax syndrome) One of the most underdiagnosed chest wall conditions. The Hooking Maneuver test is diagnostic. Often misdiagnosed as gallbladder disease or IBS for years.
→ Likely rib fracture — needs CT scan X-rays miss up to 50% of rib fractures. A CT scan is required for reliable diagnosis. Multiple fractures require specialist review.
→ Likely intercostal neuralgia or early shingles Dermatomal distribution is the key feature. Shingles can cause severe pain before any rash appears — don't wait to see a doctor.
→ Pleurisy, PE, or pneumonia — urgent assessment needed Pleuritic chest pain (worse on inspiration) requires urgent investigation to exclude pulmonary embolism and other serious causes. Go to A&E if in doubt.
→ Likely intercostal muscle strain Usually self-resolving with rest and anti-inflammatories. If it persists beyond 4–6 weeks, specialist assessment is worthwhile.
→ Exclude chest wall tumour — CT or MRI indicated Rare but important. Progressive unexplained bony pain requires imaging to exclude primary or secondary chest wall malignancy.
→ Post-thoracotomy pain syndrome — specialist management needed Intercostal nerve injury during surgery causes chronic pain that requires specialist pain management — not something a GP can easily treat.
Navigating the system

Which specialist do you actually need for chest and rib pain?

One of the most frustrating aspects of chest wall pain is being referred to the wrong specialist — resulting in normal test results and no answers. Here's how to navigate this correctly.

Step one
👨‍⚕️

GP / A&E

The appropriate first contact — especially to rule out cardiac and respiratory causes. Once serious causes are excluded, they should refer to a specialist.

Rule out cardiac causes (ECG, troponin)
Rule out infection (X-ray, bloods)
Initiate basic pain management
Chest wall pain specialist
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Thoracic Surgeon / Chest Wall Specialist

The specialist best placed to assess and treat pain arising from the chest wall — ribs, cartilage, pleura, and intercostal nerves.

Slipping rib syndrome / Cyriax syndrome
Rib fractures — multiple, complex, or non-healing
Chest wall tumours or lumps
Pleural disease (pleurisy, effusion)
Post-surgical chest wall pain
Costochondritis / Tietze unresponsive to GP care
Specific conditions
⚕️

Other Specialists

Certain causes of chest pain require referral to other physicians depending on the underlying diagnosis.

Cardiologist — cardiac causes confirmed/suspected
Rheumatologist — inflammatory chest wall arthritis
Gastroenterologist — GORD / oesophageal
Pain clinic — complex neuralgia, chronic pain
Not sure which category you fall into? A thoracic specialist consultation assesses the full picture and refers onward if needed. You won't be bounced around.
Book a Consultation →
Free Patient Resource

100 Most Common Chest Wall Pain
Questions & Answers

When surgery is needed — and when conservative treatment is the right choice
What to expect from diagnosis through to full recovery
Questions patients wish they'd asked before their first consultation

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How the diagnosis is made

The diagnostic pathway for chest and rib pain

Good diagnosis follows a logical sequence — ruling out serious causes first, then using targeted tests to identify the specific musculoskeletal or structural problem.

1

Detailed history — the most important diagnostic tool

Where exactly is the pain? What type — sharp, burning, aching, stabbing? What makes it worse — breathing, movement, pressing? When did it start and what triggered it? Does it radiate? These answers alone often point strongly to a diagnosis before any examination has been performed. A thorough clinical history takes time — and is where most brief GP appointments fall short.

2

Physical examination — often where the diagnosis is made

Palpation of the chest wall identifies the precise location of tenderness and its character (bone, cartilage, muscle, joint). The Hooking Maneuver assesses rib hypermobility. Percussion and auscultation assess the lungs and pleura. Provocative movements reproduce the specific pain. For many chest wall conditions — particularly slipping rib syndrome and costochondritis — the diagnosis is made entirely on examination, with no imaging needed.

3

Targeted imaging — chosen for the specific suspected diagnosis

Chest X-ray: rules out pneumonia, pneumothorax, pleural effusion; misses up to 50% of rib fractures. CT scan: definitive for rib fractures, chest wall tumours, pleural disease. MRI: excellent for soft tissue — cartilage, muscle, nerve. Dynamic ultrasound: the key investigation for slipping rib syndrome — shows rib movement in real time. Bone scan: for suspected stress fractures or metastatic bone disease. The right imaging depends on the clinical suspicion — not a blanket approach.

4

Diagnostic nerve block — confirms and treats simultaneously

Injecting local anaesthetic alongside a specific intercostal nerve both confirms that this nerve is responsible for the pain (if pain is abolished, the nerve is the source) and provides immediate, temporary relief. For conditions like slipping rib syndrome and intercostal neuralgia, a nerve block is both a diagnostic tool and a first-line treatment. It also guides surgical planning if intervention is ultimately needed.

A structured approach to relief

Treatment options for chest and rib pain

Treatment is always directed at the underlying cause — there is no single solution. Here's a clear overview of the main approaches, from self-management through to specialist intervention.

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First line

Self-management & conservative care

For mild musculoskeletal chest wall pain: regular NSAIDs (ibuprofen, naproxen), ice in the first 48 hours then heat, avoiding the specific activities or postures that aggravate pain, breathing exercises to prevent secondary complications, and gentle graduated activity. Adequate for many simple cases of costochondritis, muscle strain, and minor rib injuries.

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First / second line

Physiotherapy

Targeted physiotherapy addresses the postural and movement abnormalities that contribute to chest wall pain. Breathing retraining, rib mobilisation, thoracic spine work, and neuromuscular exercises provide meaningful benefit for costochondritis, muscle strain, and post-fracture rehabilitation. Best delivered by a physiotherapist with specific chest wall experience.

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Specialist

Injections & nerve blocks

Local anaesthetic and steroid injections into the costochondral joint, alongside the intercostal nerve, or under ultrasound guidance into specific structures. Can provide sustained relief lasting weeks to months. Also used diagnostically to confirm the source of pain before considering surgical options.

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Specialist

Nerve pain medications

For intercostal neuralgia and post-thoracotomy pain: gabapentin, pregabalin, amitriptyline, and topical lidocaine patches address the nerve sensitisation that drives ongoing pain even after the initial cause has resolved. Require careful titration and monitoring — a pain specialist or neurologist input is often beneficial.

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Surgical

Surgery for structural problems

When conservative and injection-based treatment has failed and a structural cause is confirmed, surgery addresses the root problem directly. Costal cartilage resection for slipping rib syndrome, rib plating (ORIF) for complex fractures or nonunion, and chest wall resection for tumours all achieve what no amount of physiotherapy can: correction of the underlying anatomy.

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Multidisciplinary

Multidisciplinary pain management

For chronic chest wall pain with significant functional impact — particularly post-surgical pain and refractory intercostal neuralgia — a pain clinic approach combining medication management, psychological support, nerve modulation techniques (TENS, radiofrequency ablation), and physiotherapy achieves better outcomes than any single intervention alone.

Already tried the basics with limited success? A specialist consultation identifies what's actually driving the pain — and which intervention is most likely to work for your specific diagnosis.
Book a Specialist Review →
Why patients choose a specialist consultation

What a chest wall specialist provides that a GP or cardiologist cannot

Chest wall pain requires a physical examination by someone who does this every day — not a protocol designed to rule out cardiac causes and discharge.

🤲

A proper physical examination

The chest wall diagnosis is made by hands — palpating specific structures, performing provocation tests like the Hooking Maneuver, and systematically identifying the exact source of pain. This takes 20+ minutes, not 5.

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The right imaging requested

Standard chest X-ray misses most rib fractures and all cartilage problems. A specialist knows which investigation answers the clinical question — dynamic ultrasound for slipping rib, CT for fractures, MRI for soft tissue.

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Diagnostic and therapeutic injections

A nerve block or cortisone injection done at consultation both confirms the diagnosis and provides relief. This is not something a GP can typically offer — it requires specialist training and equipment.

⚡

Seen within days, not months

Most patients are seen within one week of contact. When chest pain is affecting your daily life — sleep, work, exercise — waiting months on an NHS waiting list is not the right answer.

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A clear plan, not a referral merry-go-round

If the problem isn't surgical, you'll leave with a clear conservative plan and the appropriate referrals. If it is surgical, you'll understand exactly what's involved and what the outcome looks like.

📞

Direct access between appointments

Questions between appointments are answered directly by Mr Scarci. You are not left wondering whether a change in symptoms matters until your next scheduled review.

Your questions answered

Frequently asked questions about chest and rib pain

  • My ECG and heart tests were normal — should I still worry about my chest pain?
    A normal ECG and normal cardiac blood tests (troponin) are very reassuring — they essentially rule out an acute heart attack and most significant cardiac causes. However, they do not explain the pain you are experiencing, which is almost certainly coming from the chest wall. Normal cardiac tests are the beginning of the diagnostic process, not the end. If your pain persists, worsens, or is significantly affecting your life, a chest wall specialist assessment is the appropriate next step.
  • What is the most common cause of chest pain that isn't cardiac?
    Musculoskeletal causes — primarily costochondritis, intercostal muscle strain, and rib-related conditions — account for the majority of non-cardiac chest pain presentations in outpatient and emergency settings. Costochondritis is particularly common and is frequently the explanation for chest pain that has been thoroughly investigated and found to have no cardiac, pulmonary, or gastrointestinal cause. The diagnosis is made clinically, which is why it is often missed when patients are seen in a setting focused on ruling out serious causes rather than performing a thorough chest wall examination.
  • How do I know if my chest pain is musculoskeletal?
    Features that strongly suggest a musculoskeletal cause include: pain that is reproducible by pressing on a specific spot; pain that worsens with specific movements (twisting, reaching, coughing); pain that changes with different positions; the absence of associated symptoms like breathlessness at rest, sweating, or palpitations; and a normal response to anti-inflammatory medication. That said, a proper clinical examination is the only way to confidently confirm a musculoskeletal cause — and to identify which specific structure is responsible.
  • How long does costochondritis last?
    Most cases of costochondritis resolve within a few weeks to a few months with appropriate management (anti-inflammatories, activity modification, and physiotherapy). However, a significant minority of patients develop chronic costochondritis that persists for many months or even years — particularly if the underlying cause is not addressed. For persistent costochondritis that isn't responding to conservative treatment, a specialist consultation is warranted — targeted steroid injections and physiotherapy guided by an experienced clinician can be significantly more effective than standard GP management.
  • Can anxiety cause real chest and rib pain?
    Yes — anxiety and stress can cause genuine, physical chest discomfort through muscle tension, hyperventilation, and heightened pain sensitivity. However, "anxiety" is also one of the most over-used explanations for undiagnosed chest pain. If you have been told your chest pain is anxiety-related without a thorough physical examination having been performed, this deserves to be reviewed. Real musculoskeletal pathology — costochondritis, slipping rib syndrome, intercostal neuralgia — is commonly misattributed to anxiety precisely because standard investigations come back normal. Anxiety and musculoskeletal pain frequently coexist, but treating the musculoskeletal cause often significantly reduces the anxiety it generates.
  • Will my insurance cover a chest wall specialist consultation?
    Chest wall consultations and investigations for chest and rib pain are covered by all major UK private health insurers under standard outpatient policies. Mr Scarci's team will verify your specific policy and handle any pre-authorisation required. If you are self-funding, a transparent consultation fee is provided in advance with no hidden extras. Given the cost of repeated A&E visits, GP appointments, and inconclusive investigations, a specialist consultation that produces a clear diagnosis often represents excellent value.
  • Do I need a GP referral to see a chest wall specialist privately?
    No. You can contact Mr Scarci's practice directly and book a consultation without a GP referral. If you have existing investigation results — ECGs, X-rays, CT scans, blood tests — please bring these to the appointment. They will not need to be repeated if already available. If your insurer requires a GP referral letter for reimbursement purposes, your GP can provide one, but this does not delay the booking process.

Chest and rib pain deserves a proper answer — not just a normal test result.

A chest wall specialist consultation takes the time to examine every structure, identify the specific source of pain, and give you a clear plan. Not another referral. Not another set of normal tests. An actual answer.

Book a Consultation → ic baseline phone 020 7459 4367
No referral needed
All major insurers accepted
Typically seen within one week
Online consultations available
References & Further Reading
Mayo Clinic Costochondritis — symptoms and causes NHS Chest pain — causes and when to get help Mr Marco Scarci Slipping rib syndrome — full specialist guide Mr Marco Scarci Rib fractures — treatment and recovery

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