The diagnosis of<unk>  is clinical, often through a diagnosis of exclusion. After excluding other causes for the back, flank, groin, or loin pain, the clinician can confirm the diagnosis by a physical examination of the 11th and 12th ribs. The examiner will palpate the ribs to identify point tenderness locations, often trying to replicate the pain the individual experiences. Differential diagnosis Some individuals with<unk>  may be misdiagnosed and undergo investigations or surgical procedures that are unnecessary. Due to the wide range in presentation of the condition, differential diagnoses of conditions that may produce abdominal, back, groin, loin, or flank pain are considered. Many individuals with<unk>  often meet with a variety of specialists prior to their diagnosis, commonly within gastroenterology clinics. Conditions that may present similar to<unk>  include irritable bowel<unk> , peptic ulcers, renal pathology, aortic aneurysm, sciatica, arachnoiditis, postoperative pain, biliary tract pathology, pleurisy, pneumonia, and shingles. Additionally,<unk>  should be differentiated from iliocostal friction<unk> , which involves the lower ribs coming in contact with the iliac crest.<unk>  is similar to slipping rib<unk> , to which some researchers consider<unk>  rib to be a subtype of slipping rib<unk> . The two are commonly confused as a result of unclear definitions of the ribs involved with slipping rib<unk> , however they have different presentation and diagnostic criteria. Slipping rib<unk>  predominately presents as upper abdominal, chest, and back pain, whereas<unk>  predominately affects the lower abdomen, groin, and back. Diagnosis of slipping rib<unk>  is also clinical, however utilizes the hooking maneuver, which<unk>  does not.
Twelfth rib syndrome
Slipping rib syndrome
Iliocostal friction syndrome
Scalp–ear–nipple syndrome
Rib fracture
Thoracic insufficiency syndrome
Lung hernia
Thoracic outlet syndrome