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A 13-year-old boy presented a 1-year history of a brief, episodic, sharp upper left abdominal pain, accompanied by chest wall deformity, which started after physical activity. The pain did not interfere with his daily functional activities. The patient denied any other symptoms, or to have sustained any injury or trauma. His family history was not significant. On examination, the patient was a tall, thin adolescent in no apparent distress (Figure). The patient's pain symptoms were reproducible with application of upward and outward pressure of the fingertips positioned at the inferior left rib margin, also known as a positive "hooking maneuver," which was indicative of slipping rib syndrome. Slipping rib syndrome, also called Cyriax syndrome, is an overlooked cause of recurrent abdominal or chest pain. Although this disorder is most common in middle-aged females, it can occur at any age. 1 The first report of this Nicol as Rodr ıguez Garc ıa, MD