In a retrospective study, rib and thoracic vertebral fractures were found to be present on posteroanterior and lateral routine chest x-rays of 57 (28.9%) of 198 alcoholic male patients and in 4 (1.8%) of 218 nonalcoholic male control subjects. The magnitude of the increased prevalence (16-fold; p < 0.001) of rib and vertebral fractures in alcoholics suggest that routine chest x-rays should be useful in the identification of problem drinking and may be used, along with other indices, in population screening for alcoholism.