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Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
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.
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 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]
The lateral part of the CVA is formed by the lower border of the 12th rib, and the medial part of the CVA is formed by the transverse processes of the lumbar vertebrae. [1] The CVA is distinct from the costovertebral joints. [2] The lower poles of the kidneys are within the CVAs. [1] A small amount of pleura extends below the ribs in the CVAs. [2]
Pain across the costal margin is most commonly caused by costochondritis. [ 6 ] The costal paradox , also known as Hoover's sign and the costal margin paradox , is a sign where the costal angle decreases upon inspiration rather than increasing, indicating chronic obstructive pulmonary disease .
In medicine, Carnett's sign is a finding on clinical examination in which abdominal pain remains unchanged or increases when the muscles of the abdominal wall are tensed. [1] [2] For this part of the abdominal examination, the patient can be asked to lift the head and shoulders from the examination table to tense the abdominal muscles.
The most common symptoms are pain and swelling around the back of the ankle. [1] The pain is typically worse at the start of exercise and decreases thereafter. [3] Stiffness of the ankle may also be present. [2] Onset is generally gradual. [1] Achilles tendinopathy is idiopathic, meaning the cause is not well understood.