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Chronic Constriction of the Sciatic Nerve and Pain Hypersensitivity Testing in Rats

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Differentiating Chronic Neuropathic Rib Pain: A Case Report.

Emily Andrews¹, Anna Klunk¹, Alberto Giardini¹

¹Philadelphia College of Osteopathic Medicine, Philadelphia, PA.

Pain Medicine Case Reports

|April 21, 2025

Summary

Intercostal neuromas can cause chronic thoracic pain after blunt trauma. Early diagnosis with musculoskeletal ultrasound aids in effective surgical treatment for this challenging condition.

Keywords:

Neuroma case report intercostal rib pain ultrasound

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Area of Science:

Pain Management
Thoracic Surgery
Diagnostic Imaging

Background:

Rib cage pain presents diagnostic challenges due to diverse causes.
Intercostal neuromas are a potential, often overlooked, source of thoracic pain.
Blunt intercostal trauma increases the likelihood of intercostal neuroma development.

Observation:

A 69-year-old male experienced debilitating thoracic pain for a decade.
Extensive medical evaluations over 10 years failed to identify the cause of his chronic pain.
The pain was ultimately attributed to an intercostal neuroma.

Findings:

Surgical resection of the intercostal neuroma provided definitive treatment.
Musculoskeletal ultrasound demonstrated significant benefits in diagnosing the neuroma.
Prompt diagnosis and intervention are crucial for managing chronic neuropathic pain.

Implications:

Clinicians should consider intercostal neuromas in patients with persistent thoracic pain, especially after trauma.
Musculoskeletal ultrasound is a valuable tool for identifying intercostal neuromas.
Timely diagnosis and surgical management can resolve chronic pain associated with intercostal neuromas.