Slipping rib syndrome presentation in a young woman

Abstract

Slipping rib syndrome (SRS) disorder is the hypermobility of the costal cartilages attached to the floating ribs. Causes include weakness of the interchondral ligaments, and less commonly congenital rib deformities or direct trauma. Due to its location (right upper quadrant) and symptomatic presentation, the differential for this syndrome is especially broad, and as a result, even though this syndrome may make up to 5% of visits for lower chest/upper abdominal pain, it is frequently underdiagnosed, and patients often undergo excessive workup. Treatment includes conservative management, physical therapy, intercostal nerve blocks and for refractory cases, surgical intervention. We describe a case of a 43-year-old female presenting with Slipping Rib Syndrome (SRS) that was confirmed with an ultrasound. In this case report, we discuss presentation of SRS, diagnostic maneuvers and image finding of SRS, and the treatment of SRS.

Keywords

• Slipping rib syndrome
• Ultrasound
• Hooking maneuver
• Interchondral ligaments