Xiphodynia

Ishizuka, Kosuke; Yokokawa, Daiki; Mori, Takahiro; Kato, Tomonori; Yamamoto, Daiki; Ikusaka, Masatomi

doi:10.1016/j.amjmed.2020.08.033

Cited by 4 publications

(7 citation statements)

References 4 publications

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“…However, in our case, the xiphoid process-sternal angle measured even at the site with the least angle was 155° (figure 2). On the other hand, the tip of the xiphoid process (arrow in figure 1) appears to be exerting anterior pressure on the soft tissues located anteriorly, and this can also be confirmed in previous literature with CT images 3–6. The rectus abdominis muscle lies in front of the xiphoid process 2.…”

Section: Discussionsupporting

confidence: 74%

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Xiphodynia with limited decrease in the xiphoid process-sternal angle but recognised compression of the rectus abdominis

Ono,

Horibata

2024

BMJ Case Rep

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A woman in her 70s presented with epigastric pain accompanied by radiating pain. Despite various examinations showing no abnormalities, tenderness was identified on palpation of the xiphoid process. The symptoms were alleviated with a local injection of lidocaine, leading to a diagnosis of xiphodynia. While previous cases have often reported a decrease in the xiphoid process-sternal angle, this case exhibited minimal reduction in the xiphoid process-sternal angle. Conversely, compression findings were observed in the soft tissues, including the rectus abdominis, anterior to the xiphoid process. This case report suggests that in the imaging diagnosis of xiphodynia, consideration of compression findings in the soft tissues anterior to the xiphoid process may also be valuable.

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Section: Discussionsupporting

confidence: 74%

“…In xiphodynia, CT scans have reported a decreased xiphoid process-sternal angle (105–135°), while healthy individuals show an angle of 172±14° 3–6. However, in our case, the xiphoid process-sternal angle measured even at the site with the least angle was 155° (figure 2).…”

Section: Discussioncontrasting

confidence: 56%

Xiphodynia with limited decrease in the xiphoid process-sternal angle but recognised compression of the rectus abdominis

Ono,

Horibata

2024

BMJ Case Rep

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“…In prior research, many cases with decreased xiphisternal angle on CT images have been reported. Maigne et al reported three cases with angles of 105°, 120°, and 135° [6], Patel et al reported one case with an angle of 100° [14], Ono et al reported one case with an angle of 128° [7], Ishizuka et al reported one case with an angle of 133° [8], and Ismail et al reported one case with an angle of 138.4° [15]. Additionally, although not explicitly stated the angles, there are numerous reports of cases with images showing a prominently upwardly curved xiphoid process [9,16–18].…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that anterior protrusion of the xiphoid process is a risk factor for xiphodynia, and several reports suggest that using imaging tests to look at the xiphoid process from the side can help diagnose xiphodynia when it sticks out forward [6][7][8][9]. The largest study conducted to date was reported by Maigne et al, who compared the xiphisternal angle between lateral CT images of the xiphoid process in three patients diagnosed with xiphodynia and 60 healthy individuals without xiphodynia.…”

Section: Introductionmentioning

confidence: 99%

A case-control study evaluating CT signs of xiphoid process associated with xiphodynia

Ono,

Horibata

2024

Preprint

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Objectives To investigate whether CT signs of the xiphoid process, such as xiphisternal angle and evidence of soft tissue compression, are useful for diagnosing xiphodynia. Design A case-control study within a cohort. Setting/Participants Participants included 1560 individuals who visited a small urban hospital in Japan for chest or abdominal pain between January 2021 and September 2023. Those who underwent CT examinations including the xiphoid process were selected. Nine individuals diagnosed with xiphodynia were assigned to the case group, while 321 individuals diagnosed with other causes of pain were assigned to the control group. Interventions The xiphisternal angle, evidence of soft tissue compression anterior to the xiphoid process, anatomical features at the tip of the xiphoid process, and anatomical morphology of the xiphoid process were compared between the two groups. Results There was no significant difference in the xiphisternal angle between the two groups. No significant differences were observed in evidence of soft tissue compression anterior to the xiphoid process or anatomical features at the tip of the xiphoid process. New anatomical signs reveal that in approximately 70% of cases, the xiphoid process curves forward and then backward. Conclusions The xiphoid process sternal angle is not useful for diagnosing xiphodynia. The curvature of the xiphoid process is frequently observed regardless of the presence of xiphodynia.

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“…Patients can report symptoms such as thoracic or abdominal wall pain, throat tightness, nausea, and referred pain to arms, shoulders, back, or neck. 1 2 3 Symptoms can often be provoked by manual compression of the sternum and the xiphoid process, which also serves as a confirmation of the diagnosis. Additionally, a chest X-ray, upper abdominal ultrasound, or conventional computed tomography (CT) scan may show a displaced or protruded xiphoid process.…”

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confidence: 99%

Xiphodynia as an Unusual Cause of Chest Pain: A Case Series

et al. 2023

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Introduction Treatment options for xiphodynia are injections with local corticosteroid injections or surgical resection of the xiphoid process. Currently, there is no consensus as to which treatment is the most optimal. Objectives The aim of this case series was to compare the safety and efficacy of conservative and surgical treatment for patients with xiphodynia. Patients and Methods A retrospective case series was performed. All patients presenting with xiphodynia between 2016 and 2021 were eligible. Demographic data and treatment regimes, including preoperative work-up and surgical technique, were extracted from the electronic patient files. In addition, all patients received a follow-up phone call with a questionnaire. Patient satisfaction was measured using the Numeric Rating Scale. Results A total of five patients, suffering from xiphodynia for up to 10 years, completed the follow-up questionnaire (median patient age, 57 years; range 51–68 years). Three of these patients initially received conservative treatment with local injections with corticosteroids for at least 6 months. One patient was satisfied with the results and did not opt for surgical treatment. Eventually, four patients were treated surgically by removing the xiphoid process. No postoperative complications were recorded and 100% of the patients who underwent a xiphoidectomy were free of symptoms and satisfied with the results. Conclusion Symptoms related to xiphodynia can be relieved using conservative or surgical treatment, where the latter seems to be a safe and effective solution.

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Xiphodynia

Cited by 4 publications

References 4 publications

Xiphodynia with limited decrease in the xiphoid process-sternal angle but recognised compression of the rectus abdominis

Xiphodynia with limited decrease in the xiphoid process-sternal angle but recognised compression of the rectus abdominis

A case-control study evaluating CT signs of xiphoid process associated with xiphodynia

Xiphodynia as an Unusual Cause of Chest Pain: A Case Series

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