PDF(Pubmed)
Abstract：
This is a comprehensive review and update on advances in the understanding and treatment of slipping rib syndrome. It covers the physiology and pathophysiology at the basis of the syndrome, epidemiology and clinical presentation as well as diagnosis. It goes on to review the available literature to provide description and comparison of the available methods for alleviation.
Slipping rib syndrome stems from irritation of intercostal nerves. It is caused by slipping of the costal cartilage and the resulting displacement of a false rib and pinning underneath the adjacent superior rib and nerve irritation. It is rare and spans genders and ages; most evidence about epidemiology is conflicting and mostly anecdotal. Risk factors include trauma and high intensity athletic activity. Presentation is of a sudden onset of pain with jerking motion; the pain can be localized, radiating or diffuse visceral. It is often alleviated by positions that offload the impinged nerve. Diagnosis is clinical, and can be aided by Hooking maneuver and dynamic ultrasound. Definitive diagnosis is with pain relief on nerve block, visualization of altered anatomy during surgery and relief after surgical correction. Initial treatment includes rest, ice and NSAIDs, as well as screening for co-morbid conditions, as well as local symptomatic relief. Injection therapy with local anesthetics and steroids can provide a diagnosis as well as symptomatic relief. Surgical correction remains the definitive treatment.
Slipping rib syndrome is a rare cause of chest pain that could be perceived as local or diffuse pain. Diagnosis is initially clinical and can be confirmed with nerve blocks and surgical visualization. Initial treatment is symptomatic and anti-inflammatory, and definitive treatment remains surgical. More recently, advanced surgical options have paved way for cure for previously hard to treat patients.
Slipping rib syndrome stems from irritation of intercostal nerves. It is caused by slipping of the costal cartilage and the resulting displacement of a false rib and pinning underneath the adjacent superior rib and nerve irritation. It is rare and spans genders and ages; most evidence about epidemiology is conflicting and mostly anecdotal. Risk factors include trauma and high intensity athletic activity. Presentation is of a sudden onset of pain with jerking motion; the pain can be localized, radiating or diffuse visceral. It is often alleviated by positions that offload the impinged nerve. Diagnosis is clinical, and can be aided by Hooking maneuver and dynamic ultrasound. Definitive diagnosis is with pain relief on nerve block, visualization of altered anatomy during surgery and relief after surgical correction. Initial treatment includes rest, ice and NSAIDs, as well as screening for co-morbid conditions, as well as local symptomatic relief. Injection therapy with local anesthetics and steroids can provide a diagnosis as well as symptomatic relief. Surgical correction remains the definitive treatment.
Slipping rib syndrome is a rare cause of chest pain that could be perceived as local or diffuse pain. Diagnosis is initially clinical and can be confirmed with nerve blocks and surgical visualization. Initial treatment is symptomatic and anti-inflammatory, and definitive treatment remains surgical. More recently, advanced surgical options have paved way for cure for previously hard to treat patients.
摘要：
这是对肋骨滑脱综合征的理解和治疗进展的全面回顾和更新。它涵盖了基于该综合征的生理学和病理生理学，流行病学和临床表现以及诊断。它继续回顾可用的文献，以提供对可用的缓解方法的描述和比较。
肋骨滑动综合征源于肋间神经的刺激。它是由肋软骨的滑动以及假肋骨的移位和相邻的上肋骨和神经刺激下面的钉扎引起的。这是罕见的，跨越性别和年龄；大多数关于流行病学的证据是相互矛盾的，而且大多是轶事。危险因素包括创伤和高强度运动活动。介绍是突然发作的剧烈运动的疼痛;疼痛可以是局部的，放射或弥漫性内脏。它通常通过卸载撞击神经的位置来缓解。诊断是临床的，并可以通过挂钩操作和动态超声辅助。明确的诊断是神经阻滞疼痛缓解，手术中解剖结构改变的可视化和手术矫正后的缓解。初始治疗包括休息，冰和NSAIDs,以及筛查共病条件，以及当地症状缓解。局部麻醉药和类固醇的注射治疗可以提供诊断和症状缓解。手术矫正仍然是确定的治疗方法。
肋骨滑动综合征是胸痛的罕见原因，可被视为局部或弥漫性疼痛。诊断最初是临床的，可以通过神经阻滞和手术可视化来确认。初始治疗是对症和抗炎，最终的治疗仍然是手术。最近,先进的手术选择为以前难以治疗的患者的治疗铺平了道路。
肋骨滑动综合征源于肋间神经的刺激。它是由肋软骨的滑动以及假肋骨的移位和相邻的上肋骨和神经刺激下面的钉扎引起的。这是罕见的，跨越性别和年龄；大多数关于流行病学的证据是相互矛盾的，而且大多是轶事。危险因素包括创伤和高强度运动活动。介绍是突然发作的剧烈运动的疼痛;疼痛可以是局部的，放射或弥漫性内脏。它通常通过卸载撞击神经的位置来缓解。诊断是临床的，并可以通过挂钩操作和动态超声辅助。明确的诊断是神经阻滞疼痛缓解，手术中解剖结构改变的可视化和手术矫正后的缓解。初始治疗包括休息，冰和NSAIDs,以及筛查共病条件，以及当地症状缓解。局部麻醉药和类固醇的注射治疗可以提供诊断和症状缓解。手术矫正仍然是确定的治疗方法。
肋骨滑动综合征是胸痛的罕见原因，可被视为局部或弥漫性疼痛。诊断最初是临床的，可以通过神经阻滞和手术可视化来确认。初始治疗是对症和抗炎，最终的治疗仍然是手术。最近,先进的手术选择为以前难以治疗的患者的治疗铺平了道路。
