Standardized Ultrasound Protocol Accurately Diagnoses SRS

Background: Slipping rib syndrome (SRS) is caused by hypermobility of the anterior false ribs due to disrupted cartilaginous articulations, leading to intercostal nerve irritation. Patients often report popping or clicking sensation and lower anterior thoracic or upper abdominal pain. Patients may be underdiagnosed due to the lack of standardized diagnostic methods. Objective: To evaluate the efficacy of a specific diagnostic ultrasound protocol with dynamic imaging. Design: Retrospective study. Methods: 301 ultrasound examinations were performed in 227 pediatric patients at a single hospital from March 2017 to May 2022. Patient demographics are provided in detail in the article. The ultrasound protocol consisted of 3 components: a static assessment of rib morphology for anomalies such as fused, hooked, or dysmorphic ribs; a dynamic assessment with the crunch maneuver (patients perform an abdominal contraction); and a second dynamic assessment with a push maneuver (upward pressure ap more...