Rib Manipulation After Thoracic Spine Osteomyelitis: What One Case Report Shows About Screening and Reassessment

Physical therapists and physical therapist assistants who see thoracic spine pain in patients with a recent infectious or medically complex history, and who want a clear account of how one published case handled screening, clearance for thrust technique, and mid-episode reassessment.

Licensed physical therapists and physical therapist assistants working in outpatient orthopaedics, hospital-based rehabilitation, and manual therapy settings. Physical therapist assistants participate under the direction of the supervising physical therapist, who holds responsibility for examination, differential screening, and plan-of-care decisions.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is based on a single open-access case report:

Prall, J.; Dunning, J.; Young, I.; Ross, M.; Escaloni, J.; Bliton, P. Pain and Disability Reduction Following Rib Manipulation in a Patient Recovering from Osteomyelitis of the Thoracic Spine. Healthcare 2025, 13, 1355.

Published 6 June 2025 under a Creative Commons Attribution licence. All findings, figures, and recommendations described in this course are those reported by the case authors. No claims have been added from other sources.

After completing this course, you will be able to:

1. Describe the patient presented in this case report, including her medical background, the level of her cleared spinal infection, and her pain, disability, and function scores at the initial examination.
2. Name the screening and differential diagnosis steps the authors reported before thrust manipulation was used, including the evidence they cited that the infection had cleared.
3. State what the authors observed after costotransverse thrust manipulation was added at the halfway point of care, and explain the limits they placed on those observations.

1. Start Here: How This Course Works
2. Podcast: Rib Manipulation After a Cleared Spinal Infection (about nine minutes)
3. A Cleared Spinal Infection and Four Months of Mid-Back Pain
4. How the Examination and Plan of Care Were Built
5. What Happened When Rib Manipulation Was Added
6. What a Single Case Cannot Establish
7. Safety Checks and Practice Implications the Authors Draw
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course is based on a single open-access case report:
2. Prall, J.; Dunning, J.; Young, I.; Ross, M.; Escaloni, J.; Bliton, P. Pain and Disability Reduction Following Rib Manipulation in a Patient Recovering from Osteomyelitis of the Thoracic Spine. Healthcare 2025, 13, 1355.
3. Published 6 June 2025 under a Creative Commons Attribution licence. All findings, figures, and recommendations described in this course are those reported by the case authors. No claims have been added from other sources.