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Sternal foramina: incidence in Greek population, anatomy and clinical considerations

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Abstract

Purpose

Sternal foramina represent developmental defects in the sternum, which occur due to incomplete fusion of the sternal ossification centers. Sternal foramina have been correlated with several clinical implications and constitute a subject of interest for the forensic practice. The aim of this study is to define their incidence in Greek population.

Methods

The presence of midline foramen was studied in 60 dried, adult sterna derived from the Anatomy Department of Medical School of Aristotle University of Thessaloniki. Measurements were made with a 0.01-mm accuracy caliber and photographic documentation was obtained. Additionally, computed tomography scanning of the sterna was performed.

Results

Sternal foramina were found in 11 subjects, resulting in an incidence of 18.3 % over the total population. In 27.3 % of the subjects with sternal foramen, a single sternal foramen was observed in the body of the sternum, while in 45.5 % of the sterna presenting sternal foramina, multiple xiphoidal foramina were noticed. In two specimens, association of xiphoidal foramina with sternal cleft was documented.

Conclusion

Sternal foramina are variant quite common in the population, with distinct imaging pattern and awareness of their existence is important for the physician.

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References

  1. Akin K, Kosehan D, Topcu A, Koktener A (2011) Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography. Skeletal Radiol 40(4):447–452

    Article  PubMed  Google Scholar 

  2. Aktan ZA, Savaş R (1998) Anatomic and HRCT demonstration of midline sternal foramina. Turk J Med Sci 28:511–514

    Google Scholar 

  3. Ashley GT (1956) The relationship between the pattern of ossification and the definitive shape of the mesosternum in man. J Anat 90(1):87–105

    PubMed Central  CAS  PubMed  Google Scholar 

  4. Babinski Marcio A, Rafael Fábio A, Steil Alisson D, Sousa-Rodrigues Célio F, Sgrott Emerson A, de Paula Rafael Cisne (2012) High prevalence of sternal foramen: quantitative, anatomical analysis and its clinical implications in acupuncture practice. Int J Morphol 30(3):1042–1049

    Article  Google Scholar 

  5. Bayaroğulları H, Yengil E, Davran R, Ağlagül E, Karazincir S, Balcı A (2014) Evaluation of the postnatal development of the sternum and sternal variations using multidetector CT. Diagn Interv Radiol 20(1):82–89. doi:10.5152/dir.2013.13121

    PubMed Central  PubMed  Google Scholar 

  6. Bhootra BL (2004) Fatality following a sternal bone marrow aspiration procedure: a case report. Med Sci Law 44(2):170–172

    Article  CAS  PubMed  Google Scholar 

  7. Cooper PD, Stewart JH, McCormick WF (1988) Development and morphology of the sternal foramen. Am J Forensic Med Pathol 9(4):342–347

    Article  CAS  PubMed  Google Scholar 

  8. Crubézy E (1992) Sternal foramina: problems arising from the study of a family. Int J Anthrop 7(1):1–7

    Article  Google Scholar 

  9. El-Busaid H, Kaisha W, Hassanali J, Hassan S, Ogeng’o J, Mandela P (2012) Sternal foramina and variant xiphoid morphology in a Kenyan population. Folia Morphol (Warsz) 71(1):19–22

    CAS  Google Scholar 

  10. Gossner J (2013) Relationship of sternal foramina to vital structures of the chest: a computed tomographic study. Anat Res Int. doi:10.1155/2013/780193

    PubMed Central  PubMed  Google Scholar 

  11. Halvorsen TB, Anda SS, Naess AB, Lewang OW (1995) Fatal cardiac tamponade after acupuncture through congenital sternal foramen. Lancet 345:1175

    Article  CAS  PubMed  Google Scholar 

  12. Ishii S, Shishido F, Miyajima M, Sakuma K, Shigihara T, Kikuchi K, Nakajima M (2011) Causes of photopenic defects in the lower sternum on bone scintigraphy and correlation with multidetector CT. Clin Nucl Med 36(5):355–358

    Article  PubMed  Google Scholar 

  13. Kulkarni R, M LB (2010) Multiple sternal foramina with associated anomalies: a case report. Anat Karnataka 4(2):42–45

  14. Kumarasamy SA, Agrawal R (2011) A large sterna foramen. Int J Anat Var 4:195–196

    Google Scholar 

  15. Macaluso PJ, Lucena J (2014) Morphological variations of the anterior thoracic skeleton and their forensic significance: radiographic findings in a spanish autopsy sample. Forenc Sci Int. doi:10.1016/j.forsciint.2014.05.009

    Google Scholar 

  16. McCormick WF (1981) Sternal foramena in man. Am J Forensic Med Pathol 2(3):249–252

    Article  CAS  PubMed  Google Scholar 

  17. McCormick WF, Flournoy LE, Rogers NL, Ross AH (1998) An unusual case of multiple mesosternal foramina. J Forensic Sci 43(3):706–707

    CAS  PubMed  Google Scholar 

  18. Moore MK, Stewart JH, McCormick WF (1988) Anomalies of the human chest plate area. Radiographic findings in a large autopsy population. Am J Forensic Med Pathol 9(4):348–354

    Article  CAS  PubMed  Google Scholar 

  19. Pevenage P, Maeseneer M, Muylle K, Osteaux M (2002) Sternal foramen simulating osteolytic lesion on scintigraphy and spet imaging. Ann Nucl Med Sci 15:227–230

    Google Scholar 

  20. Platzer W (2008) Color Atlas of Human Anatomy locomotor system, vol 1, 6th edn. Thieme, Germany

    Google Scholar 

  21. Rhodes Lloter F (2004) Sternal foramen vs orifice of a gunshot wound. Cuad Med Forense 35:72–74

    Google Scholar 

  22. Saccheri JP, Sabbadini G, Toso F, Travan L (2012) A keyhole-shaped sternal defect in an ancient human skeleton. Surg Radiol Anat 34:965–968

    Article  PubMed  Google Scholar 

  23. Schratter M, Bijak M, Nissel H, Gruber I, Schratter-Sehn AU (1997) Foramen sternale: Kleine Anomalie-grobe Relevanz. Fortsehr Rontgenstr 166:69–71

    Article  CAS  Google Scholar 

  24. Shivakumar GL, Deepa G, Kadlimatti HS (2013) Variations in the human sterna. J Evol Med Dent Sci 2(2):99–104

    Article  Google Scholar 

  25. Singh J, Pathak RK (2013) Sex and age related non-metric variation of the human sternum in a northwest indian postmortem sample: a pilot study. Int Forensic Sci. doi:10.1016/j.forsciint.2013.02.002

    Google Scholar 

  26. Stark P (1985) Midline sternal loramen: CT demonstration. J Comp Assist Tomogr 9:489–490

    Article  CAS  Google Scholar 

  27. Taylor HL (1974) The sterna foramen: the possible forensic misinterpretation of an anatomic abnormality. J Forens Sci 19(4):730–734

    Article  Google Scholar 

  28. Xie YZ, Wang BJ, Yun JS, Chung GH, Ma ZB, Li XJ, Kim IS, Chai OH, Han EH, Kim HT, Song CH (2014) Morphology of the human xiphoid process: dissection and radiography of cadavers and MDCT of patients. Surg Radiol Anat 36(3):209–217

    Article  CAS  PubMed  Google Scholar 

  29. Yekeler E, Tunaci M, Tunaci A, Dursun M, Acunas G (2006) Frequency of sternal variations and anomalies evaluated by MDCT. AJR 186:956–960

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to George Paraskevas.

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Paraskevas, G., Tzika, M., Anastasopoulos, N. et al. Sternal foramina: incidence in Greek population, anatomy and clinical considerations. Surg Radiol Anat 37, 845–851 (2015). https://doi.org/10.1007/s00276-014-1412-5

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  • DOI: https://doi.org/10.1007/s00276-014-1412-5

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