title: The effectiveness of costal cartilage excision in children for slipping rib syndrome.
abstract: OBJECTIVE
  Slipping rib syndrome (SRS) is an elusive diagnosis. Previous reports have been single cases or small series. We previously reported a small multicenter review with encouraging early results. We now describe our matured experience.
  
  
  METHODS
  This is a follow-up study of patients with SRS from 2006 to 2015. Included are 5 previously analyzed patients and 25 new patients. Patients were called to review current symptoms, course, and satisfaction.
  
  
  RESULTS
  From 2006 to 2015, 30 patients underwent 38 operations. Eight underwent re-operation. All had reproducible pain localized to the costal margin, 60% had a popping sensation, and 23% were bilateral. 86% were female. Median age of symptom onset was 14 (IQR 13.75-15) years, while median age at diagnosis was 16 (IQR 15-17). Contact was possible with 18/30 patients, and mean follow up time was 1.3years. 72% of those felt they were cured, and 44% rated satisfaction a 10/10 (mean 7.84). Of those not cured, all reported significant improvement.
  
  
  CONCLUSIONS
  Costal cartilage excision is an effective treatment for SRS and should be considered early in the workup of costal margin pain in a normally active population. Case Series with no Comparison Group - Level IV.
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Gould
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Rentea
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Ashwini S
authors.initials: AS
authors.lastname: Poola
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO.
authors.forename: Pablo
authors.initials: P
authors.lastname: Aguayo
authors.affiliation: Department of Surgery, Children's Mercy Hospital, Kansas City, MO. Electronic address: sspeter@cmh.edu.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
mesh_terms: D000293:Adolescent; D002357:Cartilage Diseases / Q000601:surgery*; D066186:Costal Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery*; D013577:Syndrome; D016896:Treatment Outcome
keywords: Cartilage excision; Costal cartilage; Pediatric; Slipping rib syndrome