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Slipping Rib Syndrome as a Cause of Chest Pain in Children

Department of Pediatrics, Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine

Victoria L. Vetter, M.D.

Department of Pediatrics, Division of Cardiology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine

Four patients with the slipping rib syndrome presenting as chest pain are described, and the appropriate literature is reviewed. In two of the patients the physicians caring for the children were initially concerned that a cardiac condition was the cause of the chest pain, and a cardiac evaluation was done. In one patient an emotional cause for the pain was first considered and then a cardiac cause was pursued. In the last patient esophagitis was thought to be the cause and the child was referred to a gastroenterologist. It is suggested that slipping rib syndrome should be considered by physicians when evaluating children with a complaint of chest pain. The condition can be easily diagnosed on physical examination and therefore may save some patients from an unnecessary cardiac or gastroentestinal evaluation.

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