Background Coughing can lead to rib fractures, which are more common in older females and those with underlying chronic respiratory or systemic conditions. We report a unique case of spontaneous multiple rib fractures in a young healthy male with hypersensitivity pneumonitis, an occurrence not previously described, highlighting the role of computed tomography in diagnosis. Case Presentation A 30‐year‐old male patient presented with a primary complaint of 2 months of cough and dyspnea and later on developed left‐sided pleuritic chest pain. Despite an initial unremarkable report from the chest x‐ray, a computed tomography scan of the chest revealed fractures of ribs four through six on the left side and features suggestive of hypersensitivity pneumonitis. The patient responded well to treatment with oral corticosteroids and analgesics. Conclusion Spontaneous rib fractures secondary to coughing are rare in young, healthy individuals but should be considered in cases of severe, persistent coughing followed by localized chest pain. Standard x‐rays may miss subtle fractures, necessitating a high index of suspicion. If pain persists despite normal x‐rays, chest computed tomography is warranted for better detection.
Tolla et al. (2026) studied this question.