Sternal foramen

Sternal foramen (or perforated sternum) is an oval foramen present at lower one-third of the sternum. It is a relatively common anatomical variation found in 2.5% to 13.8% of individuals.[1]

Sternal foramen seen on three-dimensionally constructed CT scan

Structure

This variation is usually present at the lower one-third of the sternal body. It has an oval shape and a unique "bow tie" appearance when seen on axial computed tomography. The diameter of the sternal foramen ranges from 6 to 16 mm with an average diameter of 6.5 mm.[2] Sometimes, the foramen can be present at the xiphod process. In extremely rare cases, the foramen is found at the manubrium.[3]

Developmentally, sternal foramen results from the incomplete fusion of the sternal bars while they are still cartilaginous.[4]

Clinical significance

Although sternal foramen is asymptomatic, it may entail a risk of serious complications from blinded sternal interventions. The foramen may be misdiagnosed as sternal fracture or a gunshot wound. Awareness of sternal foramen is also crucial in acupuncture to avoid cardiac tamponade.[5]

Additional images
  • Sternal foramen on axial and sagittal CT. The "bow tie" appearance is seen on the axial view.
    Sternal foramen on axial and sagittal CT. The "bow tie" appearance is seen on the axial view.
  • Sternal foramen and xiphoid foramen
    Sternal foramen and xiphoid foramen
  • Sternal foramen observed in dry skeleton
    Sternal foramen observed in dry skeleton
  • A 3D file showing a sternum with sternal foramen and xiphoid foramen
    A 3D file showing a sternum with sternal foramen and xiphoid foramen

See also

References
  1. Choi, Paul J; Iwanaga, Joe; Tubbs, R. Shane (2017). "A Comprehensive Review of the Sternal Foramina and its Clinical Significance". Cureus. 9 (12): e1929. doi:10.7759/cureus.1929. ISSN 2168-8184. PMC 5805319. PMID 29456905.
  2. Tandon, Aseem; Gara, Rama Devi (2016-01-01). "Sternal foramen". Medical Journal of Dr. D.Y. Patil University. 9 (1): 127. doi:10.4103/0975-2870.167974. ISSN 0975-2870.
  3. Bayaroğulları, Hanifi; Yengil, Erhan; Davran, Ramazan; Ağlagül, Ela; Karazincir, Sinem; Balcı, Ali (2014). "Evaluation of the postnatal development of the sternum and sternal variations using multidetector CT". Diagnostic and Interventional Radiology (Ankara, Turkey). 20 (1): 82–89. doi:10.5152/dir.2013.13121. ISSN 1305-3612. PMC 4463249. PMID 24100061.
  4. Ashley, G. T. (1956). "The relationship between the pattern of ossification and the definitive shape of the mesosternum in man". Journal of Anatomy. 90 (Pt 1): 87–105. ISSN 0021-8782. PMC 1244824. PMID 13295154.
  5. Chung, Ainee; Bui, Luke; Mills, Edward (2003-08-01). "Adverse effects of acupuncture. Which are clinically significant?". Canadian Family Physician. 49 (8): 985–989. ISSN 0008-350X. PMC 2214278. PMID 12943357.
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