Episternal ossicles
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View Mostafa Elfeky's current disclosures- Suprasternal ossicles
- Episternal ossicle
- Suprasternal ossicle
- Breschet's bone(s)
Episternal (or suprasternal) ossicles are accessory bones and a normal variant of the sternum. They result from supernumerary ossification centers and are seen in ~4% (range 1-7%) of the population.
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Gross anatomy
Episternal ossicles are usually located posterior or superior to the superior border of the manubrium and may be unilateral or bilateral. They range in diameter from 2-15 mm and are located in a retro- or supra-manubrial location.
In three dimensions, they are quadrilateral pyramids whose bases articulate with the manubrium. The apices point medially, but rounding of the corners may mask this appearance.
Radiographic features
Their visualization using radiographs can be difficult but with the use of computed tomography are clearly identifiable, revealing unilateral or bilateral triangular ossicles in a retro- or supra-manubrial location.
Differential diagnosis
- parasternal ossicles: within the 1st costal cartilage
It is also important to differentiate them from:
- calcified lymph nodes
- fracture fragments
- vascular calcifications
- foreign bodies
- osteophytes
References
- 1. Restrepo CS, Martinez S, Lemos DF et-al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 2009;29 (3): 839-59. doi:10.1148/rg.293055136 - Pubmed citation
- 2. Stark P, Watkins GE, Hildebrandt-Stark HE et-al. Episternal ossicles. Radiology. 1987;165 (1): 143-4. Pubmed citation
- 3. Koehler/Zimmer's Borderlands of Normal and Early Pathological Findings in Skeletal Radiography. Thieme. (2003) ISBN:3131606355. Read it at Google Books - Find it at Amazon
- 4. Wright FW. Radiology of the chest and related conditions. CRC Press. ISBN:0415281415. Read it at Google Books - Find it at Amazon
- 5. Hatfield MK, Gross BH, Glazer GM et-al. Computed tomography of the sternum and its articulations. Skeletal Radiol. 1984;11 (3): 197-203. Pubmed citation
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