CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2016; 26(02): 185-194
DOI: 10.4103/0971-3026.184407
Cardiothoracic Imaging

MDCT evaluation of sternal variations: Pictorial essay

Chary Duraikannu
VRR Scan –Department of Radiology (A Unit of VRR Diagnostics Services Pvt Ltd), Chennai, Tamil Nadu, India
,
Olma V Noronha
VRR Scan –Department of Radiology (A Unit of VRR Diagnostics Services Pvt Ltd), Chennai, Tamil Nadu, India
,
Pushparajan Sundarrajan
VRR Scan –Department of Radiology (A Unit of VRR Diagnostics Services Pvt Ltd), Chennai, Tamil Nadu, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Sternal variations and anomalies have been identified in the past during autopsy or cadaveric studies. Recently, an increasing number of minor sternal variations have been reported with the advent of multidetector computed tomography (CT). Although there are many sternal variations that occur with varying appearance and prevalence, most of them are not recognized or are underreported during routine imaging of thorax. Identification of sternal variations is important to differentiate from pathological conditions and to prevent fatal complications prior to sternal interventions like marrow aspiration or acupuncture. This article aims to describe the minor and asymptomatic sternal variations by multidetector CT and their clinical significance.



Publication History

Article published online:
30 July 2021

© 2016. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Cooper PD, Stewart JH, McCormick WF. Development and morphology of the sternal foramen. Am J Forensic Med Pathol 1988;9:342-7.
  • 2 Moore MK, Stewart JH, McCormick WF. Anomalies of the human chest plate area. Radiographic findings in a large autopsy population. Am J Forensic Med Pathol 1988;9:348-54.
  • 3 Ogawa K, Fukuda H, Omori K. Suprasternal bone (author's translation). Nihon Seikeigeka Gakkai Zasshi 1979;53:155-64.
  • 4 Keats TE, Anderson MW. Atlas of Normal Roentgenvariants that May Simulate Disease. 7th ed. Chicago, IL: Year Book; 2001. p. 438-49.
  • 5 Stark P. Midline sternal foramen: CT demonstration. J Comput Assist Tomogr 1985;9:489-90.
  • 6 Schratter M, Bijak M, Nissel H, Gruber I, Schratter-Sehn AU. The foramen sternale: A minor anomaly-great relevance. Rofo 1997;166:69-71.
  • 7 Haje SA, Harcke HT, Bowen JR. Growth disturbance of the sternum and pectus deformities: Imaging studies and clinical correlation. Pediatr Radiol 1999;29:334-41.
  • 8 Yekeler E, TunaciM, Tunaci A, Dursun M, Acunas G. Frequency of sternal variations and anomalies evaluated by MDCT. AJR Am J Roentgenol 2006;186:956-60.
  • 9 Stark P, Watkins GE, Hildebrandt-Stark HE, Dunbar RD. Episternal ossicles. Radiology 1987;165:143-4.
  • 10 Babinski MA, de Lemos L, Babinski MS, Gonçalves MV, De Paula RC, Fernandes RM. Frequency of sternal foramen evaluated by MDCT: A minor variation of great relevance. Surg Radiol Anat 2015;37:287-91.
  • 11 Bayaroğulları H, Yengil E, Davran R, Ağlagül E, Karazincir S, Balcı A. Evaluation of the postnatal development of the sternum and sternal variations using multidetector CT. Diagn Interv Radiol (Ank) 2014;20:82-9.
  • 12 Akin K, Kosehan D, Topcu A, Koktener A. Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography. Skeletal Radiol 2011;40:447-52.
  • 13 Larsen WJ. Human Embryology. 2nd ed. New York, NY: Churchill Livingstone; 1997. p. 77-8.
  • 14 O'Neal ML, Dwornik JJ, Ganey TM, Ogden JA. Postnatal development of the human sternum. J Pediatr Orthop 1998;18:398-405.
  • 15 Fokin AA. Cleft sternum and sternal foramen. Chest Surg Clin N Am 2000;10:261-76.
  • 16 Goodman LR, Teplick SK, Kay H. Computed tomography of the normal sternum. AJR Am J Roentgenol 1983;141:219-23.
  • 17 Gray H, Williams PL, Bannister LH. Gray's Anatomy: The Anatomical Basis of Medicine and Surgery. New York, NY: Churchill Livingstone; 1995.
  • 18 Restrepo CS, Martinez S, Lemos DF, Washington L, McAdams HP, Vargas D, et al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics 2009;29:839-59.
  • 19 Stark P, Jaramillo D. CT of the sternum. AJR Am J Roentgenol 1986;147:72-7.
  • 20 Sebes JI, Salazar JE. The manubriosternal joint in rheumatoid disease. AJR Am J Roentgenol 1983;140:117-21.
  • 21 Parker VS, Malhotra CM, Ho G Jr, Kaplan SR. Radiographic appearance of the sternomanubrial joint in arthritis and related conditions. Radiology 1984;153:343-7.
  • 22 Ishii S, Shishido F, Miyajima M, Sakuma K, Shigihara T, Kikuchi K, et al. Causes of photopenic defects in the lower sternum on bone scintigraphy and correlation with multidetector CT. Clin Nucl Med 2011;36:355-8.
  • 23 Wolochow MS. Fatal cardiac tamponade through congenital sternal foramen. Lancet 1995;346:442.
  • 24 Bhootra BL. Fatality following a sternal bone marrow aspiration procedure: A case report. Med Sci Law 2004;44:170-2.
  • 25 Halvorsen TB, Anda SS, Naess AB, Levang OW. Fatal cardiac tamponade after acupuncture through congenital sternal foramen. Lancet 1995;345:1175.
  • 26 Biswas G, Khandelwal NK, Venkatramu NK, Chari PS. Congenital sternal cleft. Br J Plast Surg 2001;54:259-61.
  • 27 James PA, McGaughran J. Complete overlap of PHACE syndrome and sternal malformation-vascular dysplasia association. Am J Med Genet 2002;110:78-84.
  • 28 Xie YZ, Wang BJ, Yun JS, Chung GH, Ma ZB, Li XJ, et al. Morphology of the human xiphoid process: Dissection and radiography of cadavers and MDCT of patients. Surg Radiol Anat 2014;36:209-17.
  • 29 Yapici Ugurlar O, Ugurlar M, Ozel A, Erturk SM. Xiphoid syndrome: An uncommon occupational disorder. Occup Med (Lond) 2014;64:64-6.
  • 30 Maigne JY, Vareli M, Rousset P, Cornelis P. Xiphodynia and prominence of the xyphoid process. Value of xiphosternal angle measurement: Three case reports. Joint Bone Spine 2010;77:474-6.
  • 31 Selthofer R, Nikolić V, Mrcela T, Radić R, Leksan I, Rudez I, et al. Morphometric analysis of the sternum. Coll Antropol 2006;30:43-7.