Injury Scenario: Wednesday, February 15, 2018: John, a 20-year-old male collegiate swimmer, was preparing for an upcoming sweet meet at his local university. While John was warming up, jumping up and down and gently swinging his arms, he noticed mild pain in the area of his right lower rib cage. John ignored the pain and decided to still compete in the swim meet. Despite the mild discomfort, John was able to complete three races during the swim meet.
Mechanism of Injury: Three days later, John could not tolerate the pain and decided to visit the school athletic trainer for assistance. During the initial injury evaluation, John complained about having problems sleeping, moderate diffuse pain in the region of his left lower rib cage (ribs …show more content…
The evaluation also revealed compression (anterior-posterior and lateral), Valsalva, and sit-up tests were positive, reproducing pain. No swelling, deformity, or ecchymosis was noted. John was also evaluated by a team physician the following day, which resulted in no further remarkable findings. Over the next four months, John activities were modified. In addition, John iced, stretched, received ultrasound treatments, used hot packs, and took over-the-counter nonsteroidal anti-inflammatory drugs. During this period, the athlete experienced intermittent periods of relief, followed by relapses as he tried to increase his activity level. Unsatisfied because of his persistent symptoms, the athlete independently sought chiropractic care four months post injury. Chiropractic care consisted of spinal manipulation and electric stimulation for 12 treatments and resulted in intermittent periods of improvement but no long-term relief. Six months post injury, the athlete was seen by a nonsurgical sports medicine physician. The physician diagnosed the condition as left …show more content…
863). Furthermore, this syndrome is frequently misdiagnosed or undiagnosed by clinicians and team physicians (Undermann et. al, 2005, p. 121). The first series of cases were not reported until 20 years later in 2011. According to Undermann et. al. (2005), "The differential diagnosis of slipping rib syndrome includes a variety of conditions, such as cholecystitis, esophagitis, gastric ulcer, hepatosplenic abnormalities, stress fracture, inflammation of the chondral cartilage, and pleuritic chest pain" (p. 121). Radiologic imaging is generally not useful in the diagnosis of slipping rib syndrome but may be of value in ruling out other conditions in the differential diagnosis. Slipping rib syndrome is relatively easy to diagnose with the simple hooking maneuver. However, it can also be a difficult injury to diagnoses if physicians are uneducated as seen with John's scenario, only took nine months to properly diagnose
Mechanism of Injury: Three days later, John could not tolerate the pain and decided to visit the school athletic trainer for assistance. During the initial injury evaluation, John complained about having problems sleeping, moderate diffuse pain in the region of his left lower rib cage (ribs …show more content…
The evaluation also revealed compression (anterior-posterior and lateral), Valsalva, and sit-up tests were positive, reproducing pain. No swelling, deformity, or ecchymosis was noted. John was also evaluated by a team physician the following day, which resulted in no further remarkable findings. Over the next four months, John activities were modified. In addition, John iced, stretched, received ultrasound treatments, used hot packs, and took over-the-counter nonsteroidal anti-inflammatory drugs. During this period, the athlete experienced intermittent periods of relief, followed by relapses as he tried to increase his activity level. Unsatisfied because of his persistent symptoms, the athlete independently sought chiropractic care four months post injury. Chiropractic care consisted of spinal manipulation and electric stimulation for 12 treatments and resulted in intermittent periods of improvement but no long-term relief. Six months post injury, the athlete was seen by a nonsurgical sports medicine physician. The physician diagnosed the condition as left …show more content…
863). Furthermore, this syndrome is frequently misdiagnosed or undiagnosed by clinicians and team physicians (Undermann et. al, 2005, p. 121). The first series of cases were not reported until 20 years later in 2011. According to Undermann et. al. (2005), "The differential diagnosis of slipping rib syndrome includes a variety of conditions, such as cholecystitis, esophagitis, gastric ulcer, hepatosplenic abnormalities, stress fracture, inflammation of the chondral cartilage, and pleuritic chest pain" (p. 121). Radiologic imaging is generally not useful in the diagnosis of slipping rib syndrome but may be of value in ruling out other conditions in the differential diagnosis. Slipping rib syndrome is relatively easy to diagnose with the simple hooking maneuver. However, it can also be a difficult injury to diagnoses if physicians are uneducated as seen with John's scenario, only took nine months to properly diagnose