Slipping Rib Syndrome: Case Report of an Iatrogenic Result Following Video-Assisted Thoracic Surgery and Chest Tube Placement

Abstract

The aim of this case report is to shed light on slipping rib syndrome (SRS), a painful and overlooked condition. A 62-year old man reported intermittent, self-resolving sharp rib pain that began after a video-assisted thoracic surgery and chest tube placement 4 years prior to presentation. The patient’s pain was associated with a rigid protrusion in the right upper quadrant, and home use of acetaminophen provided no relief. After physical examination, multiple imaging and lab tests, the patient was diagnosed with SRS and was referred to physical therapy and thoracic surgery for further evaluation. SRS is an under-recognized cause of upper abdominal and lower thoracic pain that should be considered if a patient’s history includes previous trauma or abdominal surgery.

Lay abstract

This is a case report of slipping rib syndrome (SRS). It is a painful medical condition. A 62-year old man after a video-assisted thoracic surgery and chest tube placement had recurrent, self-resolving sharp rib pain. The pain was associated with a rigid lump in the right lower rib cage. Acetaminophen and narcotics provided no relief. After physical examination, multiple imaging and lab tests, he was diagnosed with SRS and was referred to physical therapy and thoracic surgery for further evaluation. SRS is an under-recognized cause of rib pain that should be considered if a patient’s history includes previous trauma or abdominal surgery.

Keywords::

• abdominal pain
• chest pain
• costal cartilage
• costal margin syndrome
• hooking maneuver
• iatrogenic
• rib pain
• slipping rib syndrome
• video-assisted thoracic surgery

Acknowledgments

The authors thank T Nelson-Mayfield, MS of Mayfield Medical Communications and KD Passalacqua, at Henry Ford Hospital, for assistance with writing and editing this manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report.