{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:56:10Z","timestamp":1790934970290,"version":"4.1.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We describe the case of a 38-year-old woman, a yoga instructor, who had pain in the right shoulder and scapular region of 4 months' duration while performing yoga. Radiography and computed tomography diagnosed delayed union of a first rib stress fracture. The delayed union of stress fracture of the first rib was successfully treated with the limiting of yoga activity and low-intensity pulsed ultrasound (LIPUS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Physicians should be aware that even yoga posing can cause stress fractures of the first rib. LIPUS therapy may be effective for delayed union in addition to rest.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.20.00893","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T15:00:33Z","timestamp":1623423633000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Delayed Union of Stress Fracture of the First Rib in a Yoga Instructor"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3608-0658","authenticated-orcid":false,"given":"Shizuka","family":"Ozawa","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7073-3854","authenticated-orcid":false,"given":"Sang Yang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan"},{"name":"Department of Orthopaedic Surgery, Showa University Northern Yokohama Hospital, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-0110","authenticated-orcid":false,"given":"Yoshimasa","family":"Fujimaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan"},{"name":"Department of Orthopaedic Surgery, Showa University Northern Yokohama Hospital, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4294-075X","authenticated-orcid":false,"given":"Keikichi","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan"},{"name":"Department of Orthopaedic Surgery, Showa University Northern Yokohama Hospital, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Inagaki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Showa University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,4]]},"reference":[{"issue":"10","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"896","DOI":"10.2106\/JBJS.18.01375","article-title":"First-rib stress fracture in overhead throwing athletes","volume":"101","author":"Funakoshi","year":"2019","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/JSM.0000000000000531","article-title":"Low-intensity pulsed ultrasound for early-stage lumbar spondylolysis in young athletes","volume":"29","author":"Tsukada","year":"2019","journal-title":"Clin J Sport Med."},{"issue":"2","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/036354659101900218","article-title":"Nonunion of a first rib fracture in a gymnast","volume":"19","author":"Proffer","year":"1991","journal-title":"Am J Sports Med."},{"issue":"1","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/JSM.0b013e3181919495","article-title":"First rib stress fracture and pseudarthrosis in the adolescent athlete: the role of costosternal anatomy","volume":"19","author":"O'neal","year":"2009","journal-title":"Clin J Sport Med."},{"issue":"4 suppl 2","key":"bib5-20240805","first-page":"e1081","article-title":"Dominant-sided first-rib stress fracture in a collegiate baseball pitcher: a case report","volume":"3","author":"Chimenti","year":"2013","journal-title":"JBJS Case Connect."},{"issue":"6","key":"bib6-20240805","first-page":"383","article-title":"Pseudoarthrosis of the first rib in a patient who practices yoga. 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