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Flail Chest-II01:26

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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History:
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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
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Related Experiment Video

Updated: Nov 23, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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Treatment and Management of Twelfth Rib Syndrome: A Best Practices Comprehensive Review.

Ivan Urits1, Nazir Noor2, Nathan Fackler3

  • 1Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Pain Physician
|January 5, 2021
PubMed
Summary

Twelfth rib syndrome, often causing chronic pain, is frequently diagnosed late. Nerve blocks and rib resection show promise for relief, but more research is needed for effective management.

Keywords:
abdominal painback painchest painchronic paininjection therapynerve blockneuropathySlipped rib

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Area of Science:

  • Pain Management
  • Surgical Pathology

Background:

  • Twelfth rib syndrome (slipping rib syndrome) is an underdiagnosed cause of chronic chest, back, flank, and abdominal pain.
  • Pain results from irritation of the 12th intercostal nerve, often leading to delayed diagnosis, psychiatric comorbidities, and increased healthcare costs.

Purpose of the Study:

  • To review twelfth rib syndrome, including its etiology, pathophysiology, epidemiology, diagnosis, and management options.

Main Methods:

  • A narrative review based on a PubMed search for seminal literature on twelfth rib syndrome.

Main Results:

  • Conservative treatments like heat, ice, rest, and analgesics are first-line options.
  • Nerve blocks offer short-term relief, while surgical rib resection may provide long-lasting pain relief.
  • Transcutaneous stimulation and 12th intercostal nerve cryotherapy have also shown some success.

Conclusions:

  • Twelfth rib syndrome leads to significant morbidity due to late diagnosis.
  • Nerve blocks and surgical rib resection are potentially effective treatments, but require further evidence.
  • Increased clinician awareness is crucial for prompt diagnosis and management.