Slipping rib syndrome

Slipping rib syndrome
Other names	Cyriax syndrome, clicking rib syndrome, painful rib syndrome, displaced ribs, interchondral subluxation
Illustration of slipping rib syndrome
Specialty	General surgery, thoracic surgery, orthopedic surgery, sports medicine
Symptoms	"Popping" or "clicking" sensation in ribs, back pain, abdominal pain, chest pain, aching pain, pain with activity/movement
Risk factors	Hypermobility, trauma
Diagnostic method	Physical examination, dynamic ultrasound
Differential diagnosis	Costochondritis, Tietze syndrome, pleurisy, rib fracture, gastric ulcer, cholecystitis, esophagitis, hepatosplenic abnormalities
Treatment	Analgesics, injections, surgery

Slipping rib syndrome (SRS) is a condition in which the interchondral ligaments are weakened or disrupted and have increased laxity, causing the costal cartilage tips to subluxate (partially dislocate). This results in pain or discomfort due to pinched or irritated intercostal nerves, straining of the intercostal muscles, and inflammation. The condition affects the 8th, 9th, and 10th ribs, referred to as the false ribs, with the 10th rib most commonly affected.

Slipping rib syndrome was first described by Edgar Ferdinand Cyriax in 1919; however, the condition is rarely recognized and frequently overlooked. A study estimated the prevalence of the condition to be 1% of clinical diagnoses in a general medicine clinic and 5% in a gastroenterology clinic, with a separate study finding it to be 3% in a mixed specialty general medicine and gastroenterology clinic.^[1][2]

The condition has also been referred to as Cyriax syndrome, clicking rib syndrome, painful rib syndrome, interchondral subluxation, or displaced ribs. The term "slipping rib syndrome" was coined by surgeon Robert Davies-Colley in 1922, which has been popularly quoted since.