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Ultrasound-Guided Intercostal Nerve Block
This is a well-established technique commonly used to help alleviate discomfort from rib pain. It is an elegant and low-risk procedure which involves the injection of a small volume of local anaesthesia and corticosteroid using US image guidance to ensure the needle is directed to the desired intercostal nerve target.
This can be a very useful method to increase the diagnostic certainty in identifying the site of your symptoms. More recently, at Rib Imaging we have been exploring the application of this intervention with therapeutic intent to help enhance the strengthening and conditioning of the chest and abdominal wall as a means to improve symptoms and long-term outcomes from surgery.
Ultrasound (US)
Our ultrasound technology utilises ultra-high-frequency sound waves to create real-time images of your body's soft tissues - a safe, 'non-ionising' technique free of radiation, widely employed in antenatal and neonatal care. At Rib Imaging, we harness ultrasound to pinpoint symptom locations, evaluate the arrangement of ribs and surrounding tissues, and guide therapeutic injections for precise medication delivery.
Dynamic Thoracic Ultrasound (DTUS)
Dynamic Thoracic Ultrasound takes advantage of real-time US imaging to allow “dynamic” assessment of the chest wall during specific manoeuvres. This is particularly advantageous in the imaging of ribs and the chest wall as certain pathologies such as slipping rib can only be triggered with specific movements.
At Rib Imaging we have refined and improved our techniques in Dynamic Thoracic Ultrasound and developed our own unique methodologies which have resulted in greater diagnostic accuracy and reproducibility. This has been particularly effective in the assessment and diagnosis of Slipping Rib Syndrome.
At Rib Imaging, we assess rib and chest wall pain in a “whole system” approach. This means that we understand symptoms to be a result of a complex dysfunction of thoracic, lower back and abdominal wall stability (“Trunk stability”).
Like all imaging techniques, US and DTUS do have limitations. The technique is user-dependent - that is to say, the diagnostic accuracy and reproducibility are highly dependent on the skill of the operator.
Computed Tomography (CT)
Computed Tomography or CT is a well-established and advanced imaging technique that makes use of x-ray “ionising radiation” to produce high-resolution images.
CT is fast and the entire scan can be performed within a single breath-hold. CT data can be analysed and manipulated to produce high-quality 3D reconstructions as well as the potential to produce “dynamic” images.
CT is a very valuable technique to assess bony pathology as well as assessing lung and cardiac disease. In more complex cases, CT can also be used to guide interventions. However, as CT makes use of x-rays, the technique does result in the absorption of a small radiation dose.
At Rib imaging, we ensure that our machines and imaging techniques have been carefully optimised to keep the radiation dose as low as reasonably possible whilst ensuring we acquire the highest resolution scan.
Magnetic Resonance Imaging (MR/MRI)
Magnetic Resonance Imaging is one of the most sophisticated, complex and technologically advanced imaging techniques available. MR makes use of ultra-powerful magnets to "excite” protons in the body in order to produce extremely high-resolution images. Like US, MR avoids radiation dose absorption and so is a safe and elegant technique to visualise soft tissues.
MR has many other advantages over other imaging techniques including the ability to characterise the structure and function of the tissue in far greater detail than other modalities.
Advancements in both scanner technology and the development of novel applications mean that MR technologies are continually evolving with several exciting techniques emerging from across the globe.
At Rib Imaging, we remain abreast of the most novel techniques and applications in order to refine and improve our diagnostic capabilities including developing dynamic imaging.
Imaging Techniques
At Rib Imaging, we employ a suite of advanced imaging techniques, each carefully chosen to maximise diagnostic precision in our unique focus on rib and chest wall disorders. Discover the technologies we use to illuminate your path to recovery.
Ultrasound (US)
Our ultrasound technology utilises ultra-high-frequency sound waves to create real-time images of your body's soft tissues - a safe, 'non-ionising' technique free of radiation, widely employed in antenatal and neonatal care.
At Rib Imaging, we harness ultrasound to pinpoint symptom locations, evaluate the arrangement of ribs and surrounding tissues, and guide therapeutic injections for precise medication delivery.
US consultations take place at our new clinic at Until Soho. Book your appointment today.
Dynamic Ultrasound of Thorax and Ribs (DUTS)
Our unique approach to Dynamic Ultrasound of Thorax and Ribs offers a real-time 'dynamic' view of the chest wall during specific movements, optimised for the diagnosis of conditions like slipping rib syndrome, visible only with certain manoeuvres. We assess rib and chest wall pain using a 'whole system' approach, factoring in thoracic, lower back, and abdominal wall stability for comprehensive insight.
While ultrasound techniques are operator-dependent, our expert team at Rib Imaging ensures maximum diagnostic accuracy through refined methodologies. This has proven especially successful in diagnosing Slipping Rib Syndrome.
DUTS consultations take place at our new clinic at Until Soho. Book your appointment today.
US-guided Intercostal nerve injections (CCSD Code A7352)
At Rib Imaging, we have refined our techniques in ultrasound-guided intercostal nerve injections, drawing on our in-depth knowledge of chest wall musculoskeletal and neuroanatomy to precisely target the intercostal nerves.
These nerves are located between the delicate intercostal muscles, just millimetres from the lung and pleura, making careful needle selection and ultrasound guidance essential for accurate medication placement.
Once correctly positioned, the medication spreads along the nerve pathway, providing effective pain relief. With one of the largest experiences in performing this procedure, we have even successfully administered it pitch-side to help athletes continue competing.
US-guided intercostal nerve blocks are performed at our new clinic at Until Soho. Book your appointment today.
Computed Tomography (CT)
Computed Tomography is a robust, advanced imaging technique using ionising radiation to create high-resolution images swiftly, often within a single breath-hold.
CT enables high-quality 3D reconstructions and dynamic images, providing valuable insight into bony, lung, and cardiac diseases. In complex cases, it guides interventions.
At Rib Imaging, we meticulously optimise our techniques and machinery, ensuring low radiation exposure while maintaining the highest resolution.
CT consultations take place at Queen Square Imaging. Book your appointment today.
Magnetic Resonance Imaging (MR/MRI)
MR Thorax is a sophisticated and advanced technique that allows high resolution imaging of the bone and soft tissue structures of chest wall in great detail. We work closely with MR engineering and physics experts to help refine and improve our techniques.
Our pioneering work at Rib Imaging has allowed us to development techniques for dynamic imaging of the thorax and abdominal wall musculature. More recently, Rib Imaging have developed our unique Intercostal neurography study which allows high definition MR imaging of the intercostal nerves.
Beyond identifying symptomatic sites, Rib Imaging use our innovative approach to imaging to help plan and guide intervention and therapies in order to enhance symptom management and surgical outcomes.
MRI consultations take place at Chenies Mews Imaging Centre and Spire St. Anthony’s Hospital. Book your appointment today.
Ultrasound (US)
Dynamic Thoracic Ultrasound (DTUS)
Ultrasound-Guided Intercostal Nerve Block
Computed Tomography (CT)
Magnetic Resonance Imaging (MR/MRI)
Conditions Diagnosed
"Dr Ali Abbasi represents one of the most experienced radiologists in the diagnosis of slipping rib syndrome with the utilisation of dynamic ultrasound."
Mr Nikolaos Panagiotopoulous
Consultant Thoracic Surgeon
Aplio i-series / Prism Edition: the forefront of ultrasound technology.
Slipping Rib Syndrome (SRS)
At Rib Imaging, we've examined hundreds of patients worldwide, earning our reputation as one of the most sought-after services for chronic rib and chest wall pain.
Our wealth of experience has enabled us to diagnose a spectrum of over 14 distinct pathologies. From previously undetected fractures and chest wall hernias to bone tumours, our precise diagnosis has guided many towards effective treatment.
Our expertise is frequently called upon for three prevalent conditions: slipping rib syndrome, costochondritis, and traumatic injuries.
Costochondritis
Costochondritis is inflammation of the costal cartilage causing rib pain and tenderness. This is a poorly characterised disorder and a difficult diagnosis to make as there is no test or scan that can be used to accurately confirm the diagnosis. As a result, costochondritis is a “clinical diagnosis” or an educated professional opinion made after other more serious conditions have been excluded.
Our work at Rib Imaging has demonstrated that rib and chest wall pain is frequently non-specific and many different conditions can present with very similar symptoms.
In many cases, patients who have previously been diagnosed with costochondritis have later been assessed at Rib Imaging and found to have other explanations for their symptoms.
Dynamic Thoracic Ultrasound is a valuable tool to assess rib pain and can help identify the location of symptoms and potential causes. It also helps in planning any subsequent advanced imaging such as CT and MR to ensure the scan is optimised.
Rib and Soft Tissue Injuries
Rib and cartilage fractures are common injuries resulting in focal pain and tenderness. Although they frequently occur from traumatic injuries, some fractures can occur in patients with weakened bones and from low energy causes such as coughing.
In many cases of traumatic injury, even when there are no fractured ribs, patients can have significant soft tissue injuries such as muscle tears which can also result in severe pain and tenderness.
Rib fractures cannot always be identified on chest x-rays, and many hospitals will decline to perform them if there are no other signs of serious complications such as pneumothorax. Soft tissue injuries such as muscle tears cannot usually be seen on chest x-rays.
Thoracic Ultrasound can be a valuable tool to identify rib and cartilage fractures and is very sensitive for identifying soft tissue injuries such as muscle tears.
Conditions Diagnosed
At Rib Imaging, we have scanned several hundreds of patients with chronic rib and chest wall pain, making us one of the highest volume services in Europe.
We have extensive experience and expertise in assessing and diagnosing a wide range of rib and chest wall conditions and to date, we have identified more than 14 different pathologies.
We have helped many patients to get the correct diagnosis including undiagnosed rib and cartilage fractures, chest wall hernia and bone tumours.
The three most common conditions that we are asked to assess regularly are slipping rib syndrome, costochondritis and traumatic injuries.
Conditions Diagnosed
At Rib Imaging, we've examined hundreds of patients worldwide, earning our reputation as one of the most sought-after services for chronic rib and chest wall pain.
Our wealth of experience has enabled us to diagnose a spectrum of over 14 distinct pathologies. From previously undetected fractures and chest wall hernias to bone tumours, our precise diagnosis has guided many towards effective treatment.
Our expertise is frequently called upon for three prevalent conditions: slipping rib syndrome, costochondritis, and traumatic injuries.
Slipping Rib Syndrome
Slipping Rib Syndrome, despite being identified nearly a century ago, remains enigmatic and often overlooked, leading to unnecessary tests and patient anxiety.
At Rib Imaging, we excel in diagnosing this elusive condition using Dynamic Thoracic Ultrasound, the gold standard diagnostic tool. Our precise techniques ensure reliable, accurate assessment, alleviating the frustration associated with misdiagnosis.
Continually honing our methodologies, including advanced imaging techniques like MRI, we are at the forefront of understanding and accurately diagnosing Slipping Rib Syndrome
Costochondritis
Costochondritis, characterised by rib pain due to inflamed costal cartilage, is a complex condition often misdiagnosed due to the absence of a confirmative test.
At Rib Imaging, we've found that rib and chest wall pain frequently mask diverse conditions with similar symptoms. Many previously diagnosed costochondritis cases were, upon our assessment, attributed to alternative causes.
We utilise Dynamic Ultrasound of the Thorax and Ribs to pinpoint the location of symptoms and identify potential sources. This not only aids in accurate diagnosis but optimises the planning for further advanced imaging such as CT and MRI.
Rib and Soft Tissue Injuries
Commonly resulting from trauma, rib and cartilage fractures cause focal pain and tenderness. However, they can also arise in those with weakened bones, often from minimal strain such as coughing.
Beyond fractures, significant soft tissue injuries like muscle tears can inflict severe pain. Chest X-rays frequently miss these fractures and fail to reveal soft tissue injuries. At Rib Imaging, we utilise Thoracic Ultrasound for detecting both rib and cartilage fractures as well as soft tissue injuries such as muscle tears.
Dr Ali Abbasi is the only person in the county I trust to investigate patients with suspected slipping rib syndrome.
Every patient who sees him tells me how meticulous he is and how well he explains his discoveries. He always goes the extra mile and contacts me within 24hrs to keep me in the loop with his findings.
Mr Joel Dunning
Consultant Thoracic Surgeon
I have worked with Dr Ali Abbasi for quite a few years building up a wealth of experience in chest wall problems. He has become an internationally recognised musculoskeletal radiology expert and, certainly in the UK, the leading radiologist in this field. I could not rate him higher. He is an exceptional colleague.
Mr Ian Hunt
Consultant Thoracic Surgeon
We are driven by our passion for acquiring the highest quality diagnostic imaging and engagement with our patients. We have helped diagnose a wide range of conditions for our patients.
