Internal Injuries: Which Specialist to Consult?

For internal injuries, you should consult a specialist in Emergency Medicine or Trauma Surgery?

On May 14, 2005, I accidentally slipped and fell at home, landing face down on the ground.
I was unable to get up for a few minutes after the fall.
After resting, I checked my body and found no obvious bruises, but I felt a dull pain in my chest.
Since the fall, I have been experiencing overall body soreness and persistent chest discomfort.
Should I be concerned about internal injuries? Which medical specialty should I consult?

jimmy, 30~39 year old female. Ask Date: 2005/05/17

Dr. Xu Zhenrong reply Physical Fitness

Dear Jimmy,
Thoracic injuries can be classified into two types based on the mechanism of injury:
1.
Closed injuries, also known as contusions or internal injuries from a traditional Chinese medicine perspective, are typically caused by blunt trauma or compression.
There is no open wound in the pleural cavity.
Mild cases may present with soft tissue contusions or simple rib fractures, while more severe cases may involve damage to thoracic organs, with clinical symptoms including pain or difficulty breathing.
2.
Open injuries involve an open wound in the pleural cavity, leading to conditions such as pneumothorax, hemothorax, or injury to intrathoracic organs.
Clinical symptoms may include pain, hemoptysis, difficulty breathing, or even shock.
Based on your description, it is more likely that you are experiencing a closed injury, specifically a contusion, and the symptoms do not appear to be severe.
However, we cannot make a definitive differential diagnosis without a clinical examination by a qualified physician.
I recommend that you visit a rehabilitation specialist for further evaluation.
The rehabilitation physician can use clinical physical examination techniques to diagnose your condition, and if necessary, you may receive professional physical therapy.
Wishing you health and a speedy recovery,
Director of Rehabilitation Medicine, Taipei City Hospital, Hsu Chen-Jung

Reply Date: 2005/05/17

More Info

If you have experienced a fall and are feeling persistent chest pain and overall body soreness, it is important to take your symptoms seriously, as they could indicate internal injuries. While you may not have visible bruises or cuts, internal injuries can occur without any external signs.
Given your symptoms, the first step is to consult a healthcare professional. In your case, it would be advisable to see a specialist in either Emergency Medicine or Internal Medicine. An emergency physician can evaluate your condition promptly, especially if there is a concern for serious injuries such as rib fractures, lung contusions, or other thoracic injuries. They may perform imaging studies like X-rays or a CT scan to assess for any internal damage.

If the emergency department rules out any acute injuries, you might then be referred to an Internal Medicine specialist or a Pulmonologist if your symptoms are primarily related to the chest. They can further investigate the cause of your chest discomfort and systemic soreness.
It’s also worth mentioning that if you experience any of the following symptoms, you should seek immediate medical attention:
1. Severe chest pain that worsens with deep breaths or coughing.

2. Shortness of breath or difficulty breathing.

3. Dizziness or fainting.

4. Rapid heart rate or palpitations.

5. Coughing up blood or any unusual discharge.

In addition to consulting a specialist, here are some general recommendations to help manage your symptoms:
- Rest: Allow your body to recover by minimizing physical activity, especially activities that may exacerbate your pain.

- Ice Therapy: Applying ice packs to the affected areas can help reduce inflammation and alleviate pain.

- Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage discomfort. However, consult with a healthcare provider before taking any medication, especially if you have underlying health conditions or are taking other medications.

- Monitor Symptoms: Keep track of any changes in your symptoms. If they worsen or new symptoms develop, seek medical attention promptly.

In summary, while it is possible that you may have sustained internal injuries from your fall, a thorough evaluation by a medical professional is essential to determine the extent of your injuries and to receive appropriate treatment. Do not hesitate to seek help, as early intervention can significantly improve outcomes in cases of internal injuries.

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