Sternum Injury and Pain

A couple days ago my 13 year son was playing on a trampoline with his friend and accidentally hit his chest on the bent knee of his friend.  It was sore and tender and also somewhat swollen but no bruising. Talked to his pediatrician and they said to keep an eye on it rest, ice, and ibuprofen which we have done.  Now the pain seems worse there is still swelling and he can barley move his arms or anything without pain.  Should I be concerned that he may have a sternal fracture or is it likely just bruised and muscle pain?  Am I better off taking him to an immediate care facility or taking him to his peditrician?
Thank you for any input on this.

[Michael L Gross, MD]

Chest contusions are very dangerous.  If they occur at a specific part of the cardiac cycle, they can lead to a fatal arrythmia at the time of injury, The death rate from these injuries is not changed by wearing chest protection, but has been decreased by the move to have cardiac conversion available at athletic  facilities. Long term, there can be other problems and I would certainly recommend evaluation by your pediatrican including a physical examination and xray.

[Dar584]

He was seen today and there was some discrepancy between there being a fracture and it just being the growth plate.  The x-rays will be looked at again tomorrow.  An EKG was also obtained.  Other than rest and no gym or sports would the treatment of a fracture vs a chest wall contusion be any different?  They did not find any other acute problems from the incident thankfully.  

[Michael L Gross, MD]

Rest, ice and analgesia as needed either way