”12th rib syndrome” is Involved in the floating ribs (11th–12th), a hypermobility of the 11th-12th ribs irritating the surrounding tissues and nervous systems.
“ Iliocostal impingement syndrome,” is Involved in the lowest ribs (11th–12th) and describes the nerve impingement beneath the lowest ribs, near the spine. This syndrome is a pathologically short distance between the lower ribs and the iliac crest caused by being too close to the L1 transverse processes.
“Twelfth rib syndrome, also known as rib tip syndrome, is a painful condition resulting from highly mobile floating ribs. It commonly presents as pain that may be felt in the lower back or lower abdominal region due to the 11th or 12th mobile rib irritating the surrounding tissues and nervous systems. The condition is often labeled as slipping rib syndrome due to the unclear definitions of the conditions, with twelfth rib syndrome sometimes being referred to as a subtype of slipping rib syndrome.“
Twelfth rib syndrome is caused by irritation of the floating ribs' intercostal nerve related to the hypermobility of the floating ribs' lack of bony attachments.
Since its first description in 1962, twelfth rib syndrome has been an often-overlooked cause of chronic chest, back, abdominal, or flank pain.
Pain from twelfth rib syndrome can be located more in the patient's back. Both are rare causes of chronic chest, back, abdominal, or flank pain that may commonly go undiagnosed or misdiagnosed, as many healthcare providers are unaware of such diagnoses.
Various positions may exacerbate or elicit pain, including lateral trunk flexion, rising to a standing position, or trunk rotation.
Twelfth rib syndrome is usually diagnosed late and causes significant morbidity and suffering. The actual epidemiology needs to be clarified, given the difficulty of diagnosis.
Nerve blocks and surgical rib resection are effective in treating this syndrome. However, further evidence is required to evaluate them properly. Familiarity with this syndrome is crucial in reaching a proper diagnosis.
Slipping rib syndrome and twelfth rib syndrome have different diagnostic criteria and treatment modalities; therefore, describing one without clarifying its difference can lead to more confusion and further delay diagnosis and appropriate care for these patients.
The 11th and 12th ribs have only costovertebral articulations.
Movement of the ribs at the costovertebral joints.
The axes of the ribs allow three basic types of motion:
Iliocostal impingement syndrome is a pathologically short distance between the lower ribs and the iliac crest caused by being too close to the L1 transverse processes.
Subcostal nerve (T11 or T12)
Iliohypogastric and Ilioinguinal nerve (both from L1)
Branches from the ventral rami (L2 and L3)
12th Rib Syndrome -Publications (1of3)
Iliocostal impingement/First lumber nerves -Publications (2 of 3)
Costotransverse and Costovertebal joints-Publications (3 of 3)
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