A 13-year-old patient presented with incapacitating right chest pain for three months, which did not relieve with analgesics.
No history of trauma.
Coastal cartilage fixation is painful, referring to the 7th right costal junction as the most painful point, without observing changes in contour or cutaneous inflammatory signs.
The hook maneuver, which consists in producing an elevation of the lower costal cartilages by introducing the explorer's fingers below the last costal arch and traction, is very painful craving.
The rest of the examination and chest X-ray are normal.
Given the characteristic examination, the SCD was suspected and a conservative treatment with oral cholera was chosen.
After one month without improvement, intercostal block or definitive surgical treatment was proposed.
Since the pain of the child is increasingly limiting and the first option would provide temporary relief, surgical intervention was performed.
At one year after diagnosis, under general anesthesia and through a transverse incision of 4 over the costal arch, we removed the 7th, 8th and 9th rib cage affected by the pericarpal tunnel.
After one year, the result was satisfactory.
