Laurie L Peterson1, Daniel G Cavanaugh. 1. Department of Pediatrics, Marshfield Clinic-Chippewa Center, 2655 County Highway 1, Chippewa Falls, WI 54729, USA. peterson.laurie@marshfieldclinic.org
Abstract
INTRODUCTION: Blunt chest trauma can occur in a variety of sports, and lead to rib fractures and less commonly known and diagnosed injuries. We report the case of a 14-yr-old student athlete who was speared (helmet tackled) in a practice scrimmage sustaining a painful injury that eluded diagnosis and treatment for more than 2 yr. METHODS: The case history of pain treatments and radiological evaluations is presented. RESULTS: Ultimately, a definitive diagnosis of "slipping rib syndrome" was achieved through a simple clinical manipulation (the hooking maneuver), combined with a history of symptomatic relief provided with costochondral blockade. Surgical resection of the slipping rib provided total resolution of the problem. CONCLUSION: Very few clinicians are aware either of the syndrome or the maneuver used to diagnose this condition. Although spearing has been outlawed in American football for years, it remains a commonplace occurrence, and sports physicians should be aware of the potential consequences to the victim as well as those to the perpetrator.
INTRODUCTION: Blunt chest trauma can occur in a variety of sports, and lead to rib fractures and less commonly known and diagnosed injuries. We report the case of a 14-yr-old student athlete who was speared (helmet tackled) in a practice scrimmage sustaining a painful injury that eluded diagnosis and treatment for more than 2 yr. METHODS: The case history of pain treatments and radiological evaluations is presented. RESULTS: Ultimately, a definitive diagnosis of "slipping rib syndrome" was achieved through a simple clinical manipulation (the hooking maneuver), combined with a history of symptomatic relief provided with costochondral blockade. Surgical resection of the slipping rib provided total resolution of the problem. CONCLUSION: Very few clinicians are aware either of the syndrome or the maneuver used to diagnose this condition. Although spearing has been outlawed in American football for years, it remains a commonplace occurrence, and sports physicians should be aware of the potential consequences to the victim as well as those to the perpetrator.
Authors: Brian E Udermann; Daniel G Cavanaugh; Mark H Gibson; Scott T Doberstein; John M Mayer; Steven R Murray Journal: J Athl Train Date: 2005-06 Impact factor: 2.860