The "hooking maneuver" being performed on a model skeleton. Diagnosing<unk>  is predominantly clinical, with a physical examination of the affected<unk>  being the most commonly utilized. A technique known as the "hooking maneuver" is commonly used amongst medical professionals to diagnose<unk> . The examiner will hook their fingers under the costal margin, then pull in an anterior (outward) and superior (upward) direction, with a positive result when movement or pain is replicated during this action. Plain radiographs, CT scans, MRI, and standard ultrasound, are all unable to visualize the cartilage affected by SRS; however, they are often used to exclude other conditions. Dynamic ultrasound is occasionally used to evaluate the dynamic laxity or displacement of the cartilage; however, it has been said to be not much superior to that of a physical examination from an experienced physician, as a diagnosis is dependent on the technician's expertise and knowledge of the condition. A positive result of a dynamic ultrasound for<unk>  requires an observed subluxation of the cartilage, which may be elicited with the Valsalva, crunch, or other maneuvers. Nerve blocking injections have also been utilized as a diagnostic method by noting the absence of pain following an injection to the intercostal nerves of the affected<unk> s. Differential diagnosis<unk>  is often confused with costochondritis and Tietze<unk> , as they also involve the cartilage of the thoracic wall. Costochondritis is a common cause of chest pain, consisting of up to 30% of chest pain complaints in emergency departments. The pain is typically diffused with the upper costochondral or sternocostal junctions most frequently involved, unlike<unk> , which involves the lower<unk>  cage. Tietze<unk>  differs from these conditions as it is often associated with swelling and swelling of the costochondral, sternocostal, and sternoclavicular joints, whereas individuals with<unk>  or costochondritis will exhibit no swelling. Tietze<unk>  typically involves the second and third<unk> s and is usually a result of infectious, rheumatologic, or neoplastic processes. A condition referred to as twelfth<unk><unk>  is similar to<unk> ; however, it affects the floating<unk> s (11-12) which do not have any attachments to the sternum. Some researchers classify<unk>  and twelfth<unk><unk>  into a group referred to as painful<unk><unk> , others classify twelfth<unk><unk>  as a subtype of<unk> , and some considering the two to be separate conditions altogether. The two disorders have different presentation and diagnostic criteria, such that a diagnosis for twelfth<unk><unk>  does not include the hooking maneuver and typically presents as lower back, abdominal, and groin pain. Other differential diagnosis includes pleurisy,<unk>  fracture, gastric ulcer, cholecystitis, esophagitis, and hepatosplenic abnormalities.
Slipping rib syndrome
Twelfth rib syndrome
Iliocostal friction syndrome
Thoracic outlet syndrome
Cuboid syndrome
Snapping scapula syndrome
Facet syndrome
Seat belt syndrome