Related Experiment Video
Updated: Sep 13, 2025
04:42
Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
14.6K
Chronic back pain: recognising twelfth rib syndrome
Andrew Chen1, Jiqing Shi2, Hong Wu3
1Department of Rehabilitation and Physical Medicine, Penn State Health, Hummelstown, Pennsylvania, USA.
BMJ Case Reports
|July 27, 2025
Summary
Twelfth rib syndrome, a rare cause of flank pain, can be overlooked. This case highlights how trigger-point injections and physical therapy effectively treated persistent pain when other methods failed.
Area of Science:
- Pain Management
- Musculoskeletal Disorders
- Case Reports
Background:
- Chronic back pain often stems from spinal issues, but rarer conditions like twelfth rib syndrome are frequently misdiagnosed.
- This can lead to prolonged suffering and ineffective treatments for patients presenting with flank pain.
Purpose of the Study:
- To present a case of twelfth rib syndrome.
- To emphasize the diagnostic importance of considering this condition in unexplained flank pain.
- To highlight effective treatment strategies.
Main Methods:
- A physical examination identified localized tenderness over the twelfth rib.
- Trigger-point injection provided immediate pain relief, confirming the diagnosis.
- Differential diagnoses were systematically excluded.
Main Results:
- The patient experienced significant symptom improvement following trigger-point injections and physical therapy.
- Twelfth rib syndrome was confirmed as the cause of persistent flank pain.
- Conservative treatments for presumed back pain had previously failed.
Conclusions:
- Twelfth rib syndrome should be considered in patients with unexplained flank pain, particularly when standard treatments are ineffective.
- Targeted interventions like trigger-point injections can significantly improve outcomes.
- Accurate diagnosis is crucial for effective pain management.
Related Concept Videos
01:27Pneumothorax-II
366
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
366
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
24
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
24
01:20The Thoracic Cage: Ribs
4.4K
Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal...
4.4K
01:24Flail Chest-I
288
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
288
01:24Chronic Pancreatitis I: Introduction
162
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
162
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
2.9K
Understanding the variety of primary symptoms and systemic complications that characterize chronic obstructive pulmonary disease (COPD) is crucial for healthcare professionals.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
2.9K