Sternal foramen

A sternal foramen, or perforated sternum, is an anatomical variation characterized by an oval-shaped opening in the lower third of the sternum, found in approximately 8.9% of individuals. It typically appears as a "bow tie" on axial CT scans and ranges from 6 to 16 mm in diameter. This developmental defect results from the imperfect union of sternal bars during embryological development and can occur in the manubrium, body, or xiphoid process of the sternum. While usually asymptomatic, a sternal foramen can pose risks during medical procedures, potentially being misdiagnosed as a fracture or gunshot wound, and presents a danger in acupuncture due to the risk of cardiac tamponade.

Reference

Pasieka, P, Pasieka, PM, Komosa, A, Barnowska, A, Pękala, J, Malinowski, K, Tomaszewski, K. (2023). Prevalence and morphometry of sternal and xiphoid foramen: a meta-analysis on 16,666 subjects. Surg Radiol Anat, 45, 623-635.

Yurasakpong L, Asuvapongpatana S, Weerachatyanukul W, Meemon K, Jongkamonwiwat N, Kruepunga N, Chaiyamoon A, Sudsang T, Iwanaga J, Tubbs RS, Suwannakhan A. (2022). Anatomical variants identified on chest computed tomography of 1000+ COVID-19 patients retrieved from an open-access dataset. Clin Anat. 35, 723-731.