Asymptomatic, an incidental finding of episternal ossicles.
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Axial and sagittal images show small pyramidal-shaped bones, bilateral and posterosuperior to the sternal manubrium. The small bones have cortical bone and fatty marrow. These bones are episternal ossicles.
Episternal ossicles are accessory bones that result from supernumerary ossification centers. They are found in 1.5 - 4% of the population. They may be uni- or bilateral and are usually pyramidal in shape. Their diameter is around 2-15 mm. Episternal ossicles are easily seen on CT, and their differential includes calcified lymph nodes, fracture fragments, vascular calcifications and foreign bodies 1.