Slipping rib syndrome.

Slipping rib syndrome (SRS) is an underdiagnosed condition that can lead to debilitating lower chest and upper abdominal pain (Am J Med Sci 2019; 357: 168). It is caused by hypermobility of the anterior ends of the costal cartilages of false ribs, allowing the eighth to tenth ribs to slip under the rib above, giving its name (Semin Pediatr Surg 2018; 27: 183). Failure to recognize this syndrome can expose patients to extensive and unnecessary investigations for unclear symptoms. Although more commonly reported in adults, SRS is a relatively uncommon but recognized cause of lower chest or upper abdomen pain in adolescence (Pediatr Anesth 2001; 11: 740). It is important for clinicians to familiarize themselves with and consider the diagnosis of SRS when assessing and managing adolescents with persistent thoracic pain. We present a case of a 14-year-old girl with unresolved thoracic pain for more than 4 years and was ultimately diagnosed with SRS.