Sternal morphological measurement is greatly important in anthropological research, clinical, and surgical approach.
Recently, multidetector computed tomography (MDCT) can be used in the sternal morphometric analysis.
Awareness of MDCT appearances of sternal variations and anomalies provides a better differential diagnosis of pathologic conditions.
The earliest fusion of the Xiphoid process with the body of the sternum found to be at thirty one years of age.
The fusion (complete or partial) of the Xiphoid process with the body of the sternum invariably present in most of the cases by the age of forty five years.
The earliest age of fusion of the manubrium with the body of the sternum found to be forty years.
The fusion (complete or partial) of the manubrium with the body of the sternum is invariably present in all the cases above fifty years.
The pattern of fusion of the sternal elements has no relation to sex.
The knowledge of anatomical variants such as congenital foramina of sternum is essential, especially for medical professionals, radiologists and acupuncturists, because of the danger of penetration of needle into pericardium during bone marrow aspiration or acupuncture. As it is asymptomatic, proper MDCT imaging could help in avoiding the risk of fatal cardiac tamponade.
The aim of this work was to measure and record the parameters of the chest and different parts of the sternum in normal Egyptian individuals in relation to age and sex, Measuring the sternal angle in different age group, Study of degree of fusion of segments of body of sternum, manubrium sterni, xiphoid process according to age, Inspection of any sternal foramen.
Subjects and methods:
This study was carried out on 240 living human Egyptian individuals of both sexes. Individuals were divided into 6 groups according to age, Group A, Their ages ranged from 10 years up to less than 20 years. Group B, Their ages ranged from 20 years up to less than 30 years, Group C, Their ages ranged from30 years up to less than 40 years, Group D, Their ages ranged from 40 years up to less than 50 years, Group E, Their ages ranged from 50 years up to less than 60 years, and Group F, Their ages were more than 60 years. Each group included 20 males and 20 females. The cases have been examined by chest CT scan in Benha university hospital and other private radiological centers. Through these chest CT films, the total length of the sternum from the jugular notch to the tip of xiphoid process, length of each part of sternum, in relation to length of thoracic part of vertebral column. The breadth of each part of sternum have been measured in relation to maximum transverse diameter of thoracic cage. The thickness of each part of sternum will be measured. The sternal angle has been measured. The degree of fusion of manubrium sternal junction and xiphisternal junction. The parts of the sternum have been examined for any foramina.
The morphometric parameters were measured using RadiAnt DICOM viewer 4.2.1(64-bit) program then measurements were analyzed statistically in relation to age and sex.
Results:
The measurements presented some variations in comparison with previous studies. These different values could be due to racial, ethnic, and regional variations. This data can be used for demographic studies, comparative studies among different population groups and forensic cases.
Conclusion:
This study indicates that the radiological study of fusion of manubrium and xiphoid process with the body of sternum is valuable index in determination of age in the living. The pattern of fusion of the sternal elements has no relation to sex.
As sternal foramen is the most common variant and it is
mostly asymptomatic. Serious complication after sterna puncture such as cardiac tamponade, and pneumothorax should be kept mind before performing an invasive procedure like a bone marrow biopsy, acupuncture, etc. It is advisable to take proper MDCT imaging to rule out such variations of the sternum.
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