Gress, BS, Charipova, BS, Georgetown University School of Medicine, Washington, DC. Kassem, MD, Schwartz, DO, Mount Sinai Medical Center, Department of Anesthesiology, Miami Beach, FL. Berger, MD, PhD, Hasoon, MD, Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA. Urits, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA. Cornett, PhD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA. Kaye, MD, PhD, Departments of Anesthesiology and Pharmacology, Toxicology and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA. Viswanath, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Valley Pain Consultants - Envision Physician Services, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE.
Psychopharmacol Bull. 2020 Oct 15;50(4 Suppl 1):189-196.
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.
这是一篇关于理解和治疗滑动肋综合征进展的全面综述和更新。它涵盖了该综合征基础的生理学和病理生理学、流行病学和临床表现以及诊断。接着回顾了现有文献，对缓解滑动肋综合征的现有方法进行了描述和比较。
滑动肋综合征源于肋间神经的刺激。它是由肋软骨滑动引起的，导致假肋移位并卡在相邻的上肋下，刺激神经。它在性别和年龄上都很少见；大多数关于流行病学的证据相互矛盾，且大多是轶事证据。危险因素包括创伤和高强度的运动活动。表现为突发疼痛伴抽搐运动；疼痛可以是局部的、放射状的或弥漫性内脏的。通过减轻受压神经的体位可以缓解疼痛。诊断是临床的，可以通过挂钩手法和动态超声辅助诊断。明确诊断是神经阻滞缓解疼痛、手术中观察到异常解剖结构和手术后缓解。初始治疗包括休息、冰敷和 NSAIDs，以及筛查合并症，以及局部对症治疗。局部麻醉剂和类固醇注射治疗可以提供诊断和症状缓解。手术矫正是最终的治疗方法。
滑动肋综合征是一种罕见的胸痛原因，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的，最终治疗仍然是手术。最近，先进的手术选择为以前难以治疗的患者提供了治愈的机会。
