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Twelfth rib syndrome, also known as rib tip syndrome, is a painful condition that occurs as a result of highly mobile floating ribs. It commonly presents as pain that may be felt in the lower back or lower abdominal region as a result of the 11th or 12th mobile rib irritating the surrounding tissues and nervous systems.
The predominant symptom is low back pain, which may radiate to the lower rib cage, flank, groin, buttock, and thigh. [2] Individuals may also experience intermittent aches along with a 'grating sensation' in the hip. [3] The pain may be aggravated by moving, twisting, bending, or by changing positions. [4]
Anatomy of the rib cage. The presentation of slipping rib syndrome varies for each individual and can present at one or both sides of the rib cage, with symptoms appearing primarily in the abdomen and back. [3] Pain is most commonly presented as episodic and varies from a minor nuisance to severely impacting quality of life.
The liver is a large, football-shaped organ located on the right upper side just under the rib cage, and it's essential for digestion and ridding the body of toxic substances, per the Mayo Clinic.
A similar condition known as slipping rib syndrome is also associated with chest pain and inflammation of the costal cartilage. [17] Unlike costochondritis, the pain associated with slipping rib syndrome is often felt in the lower ribs, abdomen, and back, commonly affecting the interchondral junctions of the false 8th to 10th ribs.
Gaenslen test - This pain provocation test applies torsion to the joint. With one hip flexed onto the abdomen, the other leg is allowed to dangle off the edge of the table. Pressure should then be directed downward on the leg in order to achieve hip extension and stress the sacroiliac joint. [1] [2]
Because of its similarities to deep vein thrombosis (DVT), May–Thurner syndrome is rarely diagnosed amongst the general population. In this condition, the right iliac artery sequesters and compresses the left common iliac vein against the lumbar section of the spine, [5] resulting in swelling of the legs and ankles, pain, tingling, and/or numbness in the legs and feet. [6]
The diagnosis can be made in the typical setting of pain or limp in a young child who is not generally unwell and has no recent trauma. There is a limited range of motion of the hip joint. Nevertheless, children with transient synovitis of the hip can usually weight bear. This is an important clinical differentiating sign from septic arthritis. [8]