Pavlo Ohorodnyk;
Schulich School of Medicine and Dentistry, Western University
Background
The objective of this presentation is to demonstrate the role of diagnostic imaging in diagnosis of xiphodynia.
Educational Goals / Teaching Points
The xiphoid process (in Greek, xiphos means “double-edged sword”) is the site of attachment of rectus abdominis, line alba, and aponeurosis of oblique muscles and diaphragmatic slips. There are many xiphoid process variants (double-ended, triple-ended, elongated, S-shaped, foramena etc.). Xiphodynia commonly presents with epigastric pain/protrusion, can mimic many serious conditions, sometimes radiating to the throat, back, and shoulders. Etiology is usually idiopathic, possibly inflammation due to trauma, displacement prompted by weight loss, or postsurgical. Several cases have suggested associations with pregnancy. Treatment sometimes requires surgery - xiphoidectomy. The objectives of this presentation is to demonstrate the role of Diagnostic Imaging in diagnosis of xiphodynia.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Role of CT in Imaging diagnosis of xiphodynia. Techniques of measurement of xiphosternal angle.
Conclusion
Imaging diagnosis of xiphodynia is based on measurement of xiphosternal angle. Findings of xiphosternal angle less than 160 degrees are pathognomonic for xyphodynia.