Bifid curved xiphoid process

Case contributed by Dr Domenico Nicoletti


Xiphodynia, swelling and pain in epigastric region for the last 3 years.

Patient Data

Age: 55 years
Gender: Female

Ventrally deviated bifid xiphoid process hook-like ending with one branch totally ossified and the other branch partial ossified. This is considered an anatomic variation.  Variations include bifurcated or trifurcated, deflected, and curved processes. No other pathologic condition was noted on the CT images.  

Case Discussion

Xiphodynia is a rare musculoskeletal disorder characterized by pain at the lower anterior chest or epigastric region. Xiphisternal angles of less than 160° or excessively long xiphoid processes have been linked to xiphodynia. The possible causes are inflammation due to mechanical injury, repeated microtrauma to the xiphoid process, displacement of the xiphoid process provoked by weight loss or previous operation affecting this region (sternotomy or median laparotomy).


Radiographer: TSRM Fabio Imola

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