BIFID XIPHISTERNUM -A RARE MORPHOLOGICAL VARIATION DURINGAUTOPSY
Keywords:
Bifid, xiphisternum, sternum, xiphoid process, congenital anomaly, morphological variationAbstract
Objectives: A bifid sternum is a rare congenital anomaly generally diagnosed as asymptomatic at birth. However sometimes it may present as chance finding in adult life during the postmortem examination. This article documents the occurrence of bifid xiphisternumduring autopsy which may be misleading and may result in serious erroneous conclusions, particularly when evaluating skeletonised human remains.Methods: Soft tissues removed from themacerated sterna by blunt dissection and the findings in xiphisternal endingrecorded. Results: Out of total fifty sternum studied bifid xiphoid process was seen in only 5 (10% ) sternums. Of these, bifid process with joined ends was found in only one (2%) sternum and bifid process with unjoined xiphoid in four (Figures 1 and 2) of the sterni. Elongated xiphisternum was found in only one of the cases (Figure 3), broad and thin in only one (2%) (Figure 4) whereas curved xiphoid was found in two of them.
References
Chakravarthi KK, Siddaraju K, Venumadhav N and
Bali SA. Anatomical and congenital variations of
human dry sternum bone: its embryogenesis and
clinical implications Int J Res Med Sci. 2018
Jan;6(1):300-304
Muscolino, Joseph E. (2008). The Muscle and Bone
Palpation Manual with Trigger Points, Referral
Patterns and Stretching. Elsevier Health Sciences.
p. 104.
Xiphoid process - Wikipedia. Accessed at: https://
en.wikipedia.org/wiki/Xiphoid_process
Mashriqi F, D’Antoni AV, Tubbs RS. Xiphoid Process
Variations: A Review with an Extremely Unusual Case
Report. Cureus2017 Aug 27;9(8):e1613
Yekeler E, Tunaci M, Tunaci A, Dursun M. Frequency
of Sternal Variations and Anomalies Evaluated by
MDCT. American J Roentgenology 2006;186: 956-960
Akin K, Kosehan D, Topcu A, Koktener A. Anatomic
evaluation of the xiphoid process with 64-row
multidetector computed tomography. Skeletal Radiol
, 40(4): 447-52.
El-Busaid H, Kaisha W, Hassanali J, Hassan
S Ogeng’o J Mandela P. Sternal foramina and variant
xiphoid morphology in a Kenyan population. Folia
Morphol (Warsz). 2012 Feb;71(1):19-22.
Shivakumar. G. L, Deepa. G, H.S. Kadlimatt. Variations
in the Human Sterna. J Evolution Med Dent Sci 2013;
(2): 99-104
Vora DH, Shah J.P, Manga HM, Khubchandani HT,
Pipaliya KN, Aghera VJ, Dabhi DM. Post Mortem
Study of Congenital Anomalies of the Sternum bone.
Natl J Integr Res Med 2014; 5(1): 37-39
Xie YZ. Wng BJ, Yun JS, Chung GH, Ma ZB, Li XJ
et al. Morphology of the human xiphoid process:
dissection and radiography of cadavers and MDCT
of patients. SurgRadiolAnat 2014
Duraikannu C, Noronha OV, and Sundarrajan P.
MDCT evaluation of sternal variations: Pictorial essay.
Indian J Radiol Imaging. 2016 Apr-Jun; 26(2): 185–194
YapiciUgurlar O, Ugurlar M, Ozel A, Erturk SM.
Xiphoid syndrome: An uncommon occupational
disorder. Occup Med (Lond) 2014;64:64–6.
Maigne JY, Vareli M, Rousset P, Cornelis P.
Xiphodynia and prominence of the xyphoid process.
Value of xiphosternal angle measurement: Three case
reports. Joint Bone Spine. 2010;77:474–6.
Macaluso PJ, Lucena J. Morphological variations of
the anterior thoracic skeleton and their forensic
significance: radiographic findings in a Spanish
autopsy sample. Forensic Sci Int.2014 Aug;241:220.
Jakhar JK, Dagar T, Dhattarwal SK, Pal V. The Sternal
Foramen: The Possible Forensic Misinterpretation of
an Anatomic Abnormality. J Indian Acad Forensic Med.
July-September 2015, 37(3).