The slipping rib syndrome.

The slipping rib syndrome is a cause of upper abdominal pain that is not widely known, possibly because of failure of recognition rather than infrequent occurrence. The syndrome should be suspected when pain can be reproduced by a rib-hooking maneuver. However, a thorough evaluation including intercostal nerve blocks is necessary both to eliminate coexistent gastrointestinal and psychiatric disorders as a cause of pain and to assure adequate treatment and a good prognosis. Patients with obvious slipping ribs appear to benefit from surgical excision.