Work

Percutaneous cryoneurolysis for intercostal neuralgia due to bifid rib in a pediatric patient

Year: 2025

Type: article

Abstract: Bifid ribs are rare congenital anomalies, usually asymptomatic and discovered incidentally on imaging. However, they can cause significant pain, posing diagnostic and therapeutic challenges, particularly in pediatric populations. We report a case of a 3-year-old female with chronic anterior chest wall pain attributed to a bifid right fourth rib. Imaging confirmed the anomaly without associated soft tissue masses. After transient symptom relief with lidocaine patches and intercostal nerve blocks, she underwent successful percutaneous image-guided cryoneurolysis of the right third to fifth intercostal nerves. The patient experienced marked pain relief post-procedure without complications, with sustained benefit at 4 months. Bifid ribs may be an under-recognized cause of intercostal neuralgia in children. Image-guided percutaneous cryoneurolysis may represent a safe and effective treatment option for symptomatic relief.

Source: Pediatric Radiology

DOI: 10.1007/s00247-025-06483-0

Authors: Joshua Verhagen, Anna Sorensen, Sarah Tracy, Eric Monroe

Institutions: University of Wisconsin–Madison, University of Wisconsin Health

Language: English

Topic: Pectus Deformity Diagnosis and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,190