A 52-year-old woman presented with abdominal pain; she had been suffering from it for three years. The pain aggravated with some non-specific positions like leaning and she described the pain as sharp, non-radiating, waxing and waning and located in the left subcostal region and lower chest. She used over the counter cyclobenzaprine and acetaminophen and also took physiotherapy sessions, but reported no improvements. Mild tenderness was noted in the left intercostal region but her physical examination was otherwise unremarkable. The tenderness could be reproduced by the hooking maneuver.
Prior imaging including CT of chest, abdomen or pelvis, MRI scans of pelvis and abdomen and X-rays failed to identify the cause. Dynamic flow ultrasound revealed slipping of the lowest rib bilaterally over the next lowest. A diagnosis of slipping rib syndrome was made. The patient was asked to avoid…
