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Related Experiment Videos

The twelfth rib syndrome

K A Cranfield1, R J Buist, P R Nandi

  • 1Department of Anaesthetics, University College London Hospitals, United Kingdom.

Journal of Pain and Symptom Management
|March 1, 1997
PubMed
Summary
This summary is machine-generated.

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Twelfth rib syndrome is a common, underdiagnosed chronic pain condition, often affecting women. Clinical diagnosis involves reproducing pain by manipulating the affected rib, avoiding unnecessary investigations.

Area of Science:

  • Pain Medicine
  • Musculoskeletal Disorders

Background:

  • Twelfth rib syndrome is a frequently encountered yet underdiagnosed cause of chronic abdominal and flank pain.
  • It disproportionately affects women (3:1 ratio) and presents with variable pain characteristics.

Observation:

  • Pain is typically a constant dull ache or sharp stabbing sensation, lasting hours to weeks.
  • Symptoms are classically exacerbated by trunk movements like lateral flexion, rotation, and arising from a seated position.
  • Direct palpation and manipulation of the affected twelfth rib and its costal cartilage precisely reproduce the patient's pain.

Findings:

  • Diagnosis is primarily clinical, relying on characteristic pain reproduction through rib manipulation after excluding other etiologies.
  • Image intensifiers may aid in precise pain locus identification for complex presentations.

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  • Six patient cases illustrate the diverse clinical manifestations of this syndrome.

    • Implications:

    • Accurate and timely diagnosis of twelfth rib syndrome can prevent extensive and unnecessary diagnostic workups and surgical interventions.
    • Increased awareness among clinicians may improve patient outcomes for this often-overlooked pain condition.