Cranfield K A, Buist R J, Nandi P R, Baranowski A P
Department of Anaesthetics, University College London Hospitals, United Kingdom.
J Pain Symptom Manage. 1997 Mar;13(3):172-5. doi: 10.1016/s0885-3924(96)00271-0.
The twelfth rib syndrome appears to be a fairly common and underdiagnosed chronic pain syndrome. It is more common in women than men (3:1) and is usually described as a constant dull ache or sharp stabbing pain that may last from several hours to many weeks. Lateral flexion, rotation of the trunk, and rising from a sitting position classically aggravate the pain. Manipulation of the affected rib and its costal cartilage reproduces it exactly. The diagnosis of this syndrome is clinical, requires exclusion of specific etiologies, and should only be made when the patient's symptoms can be exactly reproduced by manipulation of the affected rib. If symptomatology is complicated, it may be necessary to use an image intensifier for accurate location of the pain locus. Patients with this syndrome can be overinvestigated and have even undergone surgical procedures when this diagnosis has been overlooked. To describe the varied presentation of this syndrome, we describe the clinical manifestations in six patients.
第十二肋综合征似乎是一种相当常见但诊断不足的慢性疼痛综合征。女性比男性更常见（3:1），通常表现为持续的隐痛或尖锐的刺痛，可持续数小时至数周。侧屈、躯干旋转以及从坐姿起身通常会加重疼痛。对患肋及其肋软骨进行手法操作会准确再现疼痛。该综合征的诊断基于临床，需要排除特定病因，且只有在通过对患肋进行手法操作能准确再现患者症状时才能做出诊断。如果症状复杂，可能需要使用影像增强器来准确定位疼痛部位。当该诊断被忽视时，患有此综合征的患者可能会接受过度检查，甚至接受手术治疗。为描述该综合征的多样表现，我们描述了6例患者的临床表现。
