Where is your xiphoid

However, if anyone experiences a tight pain in the lower sternum for more than a week, they should seek medical attention. Xiphoid process pain can be triggered by many different causes and is most commonly a result of acute chest trauma.

Inflammation of the region can cause a lump to develop that may be mistaken for a more serious condition, such as a tumor or a hernia. Some fractures or breaks may require the xiphoid process to be surgically removed to prevent more serious internal damage. Anxiety is a condition affecting a great number of people for a range of causes. One of its effects can be chest pain similar to a heart attack.

Slipping rib syndrome is a condition where the ribs slip away from their usual position. Learn about the symptoms and when to see a doctor. The rib cage protects vital organs, such as the heart and lungs. Angina is pain, squeezing, or pressure in the chest. It signals that too little oxygen is reaching the heart. Learn more here, including when to seek…. Sternum pain can result from a variety of causes.

These range from medical conditions, such as acid reflux or costochondritis, to traumatic events…. He had used anti-inflammatory medication intermittently and yet had no complete relief. He had also undergone gastric endoscopy the previous year because of a provisional diagnosis of an ulcer as a result of pain and swelling in the epigastric region. Finally, his symptoms were attributed to gastro-oesophageal reflux and he used anti-reflux treatment for 14 months without pain relief.

On physical examination, an immobile, mass-like protrusion was palpated in the xiphoid region. The patient had a history of chronic repeated microtraumas to his sternum, as he had worked as a carpenter for 9 years.

He mentioned that in his work, he placed pieces of wood against his anterior chest wall and pushed them forward into a plank cutting machine. We concluded that in using his anterior chest wall repeatedly in this way he had caused chronic damage to the xiphoid process.

He underwent routine laboratory tests with unremarkable results. Chest radiographs in two projections posteroanterior and lateral showed ventral deviation of the xiphoid process on the lateral view, explaining the mass-like protrusion palpated on the chest wall Figure 1.

To exclude any bony lesion causing such symptoms, a CT scan of the thorax Siemens Somatom Spirit, multi-slice CT, Erlangen, Germany was performed and reformatted images in coronal, sagittal and axial planes were obtained. On the sagittal images, the patient had a ventrally deviated xiphoid process confirming the lateral chest X-ray findings Figure 2. No other chest wall or upper abdominal mass was identified.

Lateral X-ray shows hook-like anterior protrusion of the xiphoid process, which can be mistaken as a mass in the epigastric region on physical examination. Thorax CT scan in the sagittal plane in reformatted image shows the hook-like anterior protrusion of the xiphoid process more clearly. This is considered an anatomic variation.

The xiphoid process was measured 4cm in the longitudinal dimension. No other pathologic condition was noted on the CT images. The patient was diagnosed as having the xiphoid syndrome according to the clinical and radiological findings. Non-steroidal anti-inflammatory drugs were prescribed for 2 weeks and he was advised to avoid pressure on his xiphoid process while at work.

The pain was relieved and his symptoms were reduced at follow-up after 3 weeks. At 3 months of follow-up, he mentioned that he used anti-inflammatory drugs only when he felt pain in his xiphoid region and that he had stopped using his anterior chest wall at work.

Trauma is an important factor in the aetiology of the xiphoid syndrome. Acceleration and deceleration injuries [ 1 ], blunt trauma to the chest [ 1 ], unaccustomed heavy lifting and aerobics have been known to precipitate xiphodynia [ 2 ], probably because of the muscular attachments to the xiphoid process.

Cardiac or thoracic surgery also involves trauma to the chest wall, which may change the morphology of the sternum and cause xiphodynia. Enomoto et al. They suggested that the xiphoid process was separated from the sternum and pulled down inferiorly by the rectus abdominis muscle and then reconnected to the sternum, so that it was elongated [ 3 ], a mechanism, which they suggested was similar to distraction osteogenesis in limb-lengthening operations [ 3 ].

Our patient had no history of any cardiac or thoracic surgery, but a history of repeated microtrauma to the sternum incurred during his work while leaning against wood and exerting force with his anterior chest wall. Well, before thinking about treatment, you need to visit your doctor first and confirm that what you do have is xiphodynia. Generally, if you have felt this pain for more than one week, then you should see a doctor for assessment.

There may be some difficulty with the diagnosis due to the fact that the xiphoid could be mistaken for a lump or a hernia. Also, because of its proximity to several bone structures, it could be mistaken for a broken rib, especially where the pain is severe.

Magnetic resonance imaging MRI or a computerized tomography CT scan will take care of the diagnosis nicely though. These tests can An x-ray can reveal damage to the xiphoid. If the x-ray results are inconclusive, your doctor may recommend further testing. The treatment for xiphodynia depends on its cause. Generally, and especially in the case of an accident, a doctor may prescribe anti-inflammatory drugs to reduce the pain.

If it is caused by weight lifting, the doctor may also recommend that you avoid intense exercise or activities that put a strain on your xiphoid. Pain caused by acid reflux would ordinarily include recommendations to avoid foods that could trigger a reflux such as chocolates, peppermint and tomatoes. Surgery may be considered as a last resort in the event of severe damage to the xiphoid such as its breaking. As mentioned earlier, if what you have is a painless bump, you may have no cause to worry.

The bump, in this case, is most probably caused by a protruding xiphoid process, an entirely natural phenomenon. This damages the structure of the xiphoid process, causing it to bend or break off. Damage can also occur from incorrect cardiopulmonary resuscitation CPR or resuscitation with too much force. A broken xiphoid process increases inflammation, which leads to pain and tenderness in the chest.

You may also experience xiphoid process pain with acid reflux. This is when stomach acid backs up into the esophagus. Acid reflux can irritate the lining of the esophagus, and since the esophagus is located behind the breastbone, xiphoid process pain can develop along with reflux symptoms.

Xiphoid process pain caused by minor trauma may resolve itself. A doctor may be able to diagnose problems with your xiphoid process based on your symptoms and the presence of a lump near your breastbone. A lump near your xiphoid process can be mistaken for a tumor or hernia. For an accurate diagnosis, your doctor may schedule an imaging test of the lower part of your breastbone. An X-ray can reveal damage to the xiphoid process.

If X-ray results are inconclusive, your doctor may recommend further testing. These tests can take pictures of the inside of your body and help identify masses, inflammation, and other abnormalities. Treatment for xiphoid process pain depends on the underlying cause and the severity of your symptoms.

If symptoms occur after a recent trauma, your doctor may prescribe a prescription anti-inflammatory to relieve pain, or recommend alternating between hot and cold therapy throughout the day. Your doctor may also suggest limiting certain activities until the injury heals. Modifying eating habits can treat xiphoid process pain associated with acid reflux disease.

Eat smaller meals five to six times a day and avoid certain trigger foods e.