Yapici Ugurlar, M. Ugurlar, A. Ozel, S. We report a case of a year-old man, complaining of swelling and pain in his epigastric region for the last 3 years. According to his medical history, he had undergone various investigations and treatments for gastro-oesophageal reflux, without relief. He had had a history of chronic repeated microtraumas to his sternum during 9 years of working as a carpenter, as a result of placing wood against his anterior chest wall and pushing the former into a plank cutting machine. On examination, a tender swelling was palpable as an immobile, hard mass showing minimal protrusion under the skin on the xiphoid process. He was diagnosed as having xiphoid syndrome.
The xiphoid process is the smallest and most inferior region of the sternum, or breastbone. At birth, it is a thin, roughly triangular region of cartilage that slowly ossifies into a bone and fuses with the body of the sternum. Clinically, the xiphoid process plays an important role as a bony anatomical landmark in the trunk and may be damaged by improperly administered CPR. The xiphoid process is located inferior to the body of the sternum. These variations in anatomy apparently do not result in any sort of change in the function of the xiphoid process and may be inherited genetically. Developmentally, the xiphoid process begins as a structure made of hyaline cartilage at birth and childhood, slowly ossifying into a bony part of the sternum.
The xiphoid process is a small extension of bone just below the sternum. Discomfort in the xiphoid process can be painful as it can affect the lower ribcage, breastbone, and several major muscles located around the abdomen and diaphragm. It is also known by other names including the metasternum, xiphisternum, and xiphoid cartilage. The xiphoid process is a tiny bone structure located at the center of the chest, just below the lower part of the sternum. However, as it hardens, it can cause some discomfort in later life for many reasons. Discomfort can range from mild to severe. A person may feel pain in muscle groups connected to the xiphoid process around the abdomen and chest. Symptoms tend to come and go, making it a challenge to diagnose. It is also possible for the area to become inflamed, causing a lump to develop around the lower sternum. This lump is a result of inflammation but can often be mistaken for a more serious medical condition, such as a tumor.
Two patients who presented with nonspecific thoracic and upper abdominal symptoms and tenderness of the xiphoid process are discussed. Both patients had undergone extensive examinations, but no source for their symptoms could be found. Plain chest radiographs revealed an anterior displacement of the xiphoid process in both patients. Physical examination confirmed this to be the primary source of discomfort.