sternalforamen

The sternal foramen, or foramen sternale, is a congenital anatomical variation in which a hole appears through the sternum, most often in the body (gladiolus). It results from incomplete fusion of the sternal ossification centers during fetal development. The defect is typically round or oval with smooth cortical margins and may be single; multiple defects are uncommon.

Location and appearance vary, but the foramen most commonly occurs in the body of the sternum, usually in the inferior portion. Its size is usually small, commonly about 0.5 to 2 centimeters in diameter, and many cases are discovered incidentally on imaging performed for other reasons.

Prevalence estimates vary by study and population. Radiographic series report rates roughly between 0.5% and 4%, while autopsy studies show similar or slightly higher frequencies in some groups. The condition is usually asymptomatic and does not require treatment.

Imaging and diagnosis typically rely on radiographs or computed tomography. On plain chest radiographs, the foramen may appear as a circular or oval radiolucent defect within the sternum with intact surrounding bone. CT, particularly with multiplanar or 3D reconstructions, clearly delineates a well-defined bony defect and helps distinguish a foramen from a traumatic fracture or other pathology.

Clinical significance centers on potential complications during procedures involving the sternum. Because mediastinal structures lie immediately behind the sternum, deep needle insertions or penetrating procedures (for example, certain acupuncture techniques or procedures involving sternal puncture) can pose a risk if they traverse the foramen. Awareness and documentation in medical records can mitigate these risks. In the absence of procedures that involve the sternum, the finding is typically left untreated.