title: Two years of debilitating pain in a football spearing victim: slipping rib syndrome.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Pediatrics, Marshfield Clinic-Chippewa Center, 2655 County Highway 1, Chippewa Falls, WI 54729, USA. peterson.laurie@marshfieldclinic.org
authors.forename: Laurie L
authors.initials: LL
authors.lastname: Peterson
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Cavanaugh
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis* / Q000628:therapy; D002637:Chest Pain / Q000175:diagnosis* / Q000628:therapy; D003951:Diagnostic Errors; D005538:Football; D006801:Humans; D008297:Male; D012272:Ribs / Q000293:injuries*