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Rib Pain In A Runner - Page #1
 

Author: Stephanie Clark, DO, MS
Co Author #1: Dr. Ronan Cahill, MD
Senior Editor: Christian Fulmer, DO
Editor: Celina Mercer, MD, MPH

Patient Presentation:
An otherwise healthy 43-year-old male endurance sport athlete presented with 8 months of insidious onset left anterior rib pain.

History:
Pain was located approximately near ribs 8-10 on the left. The pain was initially exacerbated only with running and improved with rest. His pain had progressed to bother him with any up-and-down movements, such as jumping and using stairs. He also developed back pain at the same vertebral level as his rib pain. His back pain was worse at night. His symptoms were described as achy, stabbing, and rated 6-7/10 in intensity. An appropriate course of physical therapy and chiropractic manipulations had provided him with minimal relief. He denied associated arm or leg weakness, numbness, tingling, bowel or bladder dysfunction, fevers, chills or recent weight loss.

Physical Exam:
Fit, healthy appearing male in no distress. Non-labored breathing on room air. Radial pulses were regular rate and rhythm and capillary refill was normal. Sensation intact to light touch. Reflexes in upper and lower extremities 2+ and symmetric. There was no chest wall asymmetry, exaggerated kyphosis or scoliosis. There was no tenderness to palpation of the anterior rib cage or spinous processes. Full pain-free range of motion with spine flexion, extension, rotation and side-bending. Normal muscle bulk and tone in upper extremities. Negative Carnett sign.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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