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Exploring Sternal Tenderness: Uncovering Different Causes of Sternal Pain

by alexxlab

What are the potential causes of sternal pain and tenderness. How can diagnostic tests help identify the underlying condition. Learn about the different conditions that can lead to sternal discomfort.

Uncovering the Causes of Sternal Tenderness

Sternal pain and tenderness can have a variety of underlying causes, ranging from benign conditions to more serious medical issues. Understanding the potential sources of this discomfort is crucial for accurate diagnosis and proper treatment. In this comprehensive article, we will delve into the different causes of sternal tenderness, the diagnostic process, and the appropriate management strategies.

Understanding Sternal Anatomy and Function

The sternum is a flat, elongated bone located in the central part of the chest wall, serving as the attachment point for the ribs and playing a crucial role in protecting the vital organs within the thoracic cavity. Sternal tenderness can arise from various conditions affecting the sternum itself, the surrounding tissues, or the structures in close proximity to the sternum.

Common Causes of Sternal Tenderness

Sternal tenderness can be attributed to a range of conditions, including:

  1. Musculoskeletal Conditions: Injuries or disorders affecting the muscles, ligaments, or joints surrounding the sternum, such as costochondritis, Tietze’s syndrome, and trauma.
  2. Inflammatory Conditions: Autoimmune disorders, such as rheumatoid arthritis or ankylosing spondylitis, can cause inflammation and pain in the sternal region.
  3. Infectious Processes: Infections, such as osteomyelitis or sternal wound infections, can lead to sternal tenderness and discomfort.
  4. Malignant Conditions: Tumors, either primary or metastatic, can originate in the sternum or surrounding tissues, causing sternal pain and swelling.
  5. Vascular Conditions: Aortic dissection or ischemic heart disease can sometimes present with sternal pain, particularly in the setting of chest discomfort.

Diagnostic Approach to Sternal Tenderness

When a patient presents with sternal tenderness, a comprehensive diagnostic evaluation is essential to determine the underlying cause. The diagnostic process typically involves:

  • A thorough medical history and physical examination
  • Diagnostic imaging, such as X-rays, CT scans, or MRI scans, to visualize any structural abnormalities or lesions
  • Laboratory tests, including blood work and, in some cases, tissue biopsy, to identify any underlying infectious, inflammatory, or neoplastic processes

Treating Sternal Tenderness

The treatment approach for sternal tenderness depends on the underlying cause. In cases of musculoskeletal or inflammatory conditions, management may involve pain medication, physical therapy, or anti-inflammatory medications. Infectious processes may require antibiotic therapy or surgical intervention. For malignant conditions, a multidisciplinary approach involving oncologists, surgeons, and other specialists may be necessary, potentially including chemotherapy, radiation therapy, or surgical resection.

Preventing Sternal Complications

To reduce the risk of developing sternal complications, it is important to maintain good posture, engage in appropriate physical activity, and promptly address any signs of sternal tenderness or discomfort. Regular check-ups with a healthcare provider can also help identify and manage any underlying conditions before they lead to more serious complications.

Key Takeaways

Sternal tenderness can have a wide range of underlying causes, from benign musculoskeletal conditions to more serious malignant or infectious processes. A comprehensive diagnostic evaluation, including imaging and laboratory tests, is crucial for identifying the root cause and guiding appropriate treatment. By understanding the potential causes of sternal pain and seeking timely medical attention, individuals can take proactive steps to manage their condition and maintain their overall health and well-being.

[Sternal pain: not always harmless]

Case Reports

. 2004 Dec 11;148(50):2469-74.

[Article in

Dutch]

R J W Hoogendoorn 
1
, J M Brinkman, O J Visser, M A Paul, P I J M Wuisman

Affiliations

Affiliation

  • 1 Afd. Orthopedie, VU Medisch Centrum, Postbus 7057, 1007 MB Amsterdam.

  • PMID:

    15638192

Case Reports

[Article in

Dutch]

R J W Hoogendoorn et al.

Ned Tijdschr Geneeskd.

.

. 2004 Dec 11;148(50):2469-74.

Authors

R J W Hoogendoorn 
1
, J M Brinkman, O J Visser, M A Paul, P I J M Wuisman

Affiliation

  • 1 Afd. Orthopedie, VU Medisch Centrum, Postbus 7057, 1007 MB Amsterdam.

  • PMID:

    15638192

Abstract

In two patients, men aged 39 and 66 years, a sternal mass in combination with pain developed. One patient was diagnosed with a non-Hodgkin lymphoma located in the sternum and the other one with a primary chondrosarcoma of the sternum. They both recovered after treatment. The differential diagnosis of disorders of the chest wall is troublesome and includes haematologic, rheumatologic and infectious processes. Tietze’s syndrome is a rare cause of pain and non-suppurative swelling of the costosternal joints. However, tumours of the anterior chest wall can also cause these symptoms and these must therefore be excluded if the complaints persist or the swelling progresses. The most common malignant tumours of the chest wall are non-Hodgkin lymphoma, primary chondrosarcoma and metastases. Diagnostics should consist of blood tests and X-rays. CT and MRI scans are more helpful in establishing the diagnosis. A definitive diagnosis can only be determined by biopsy.

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An Evaluation of Sternal Tenderness as a Sign of Leukaemia | Acta Haematologica

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Research Articles|
March 06 2009

G.M. McAndrew;

D. Ogston;

Audrey A. Dawson

Acta Haematol (1970) 43 (5): 309–312.

https://doi.org/10.1159/000208742

Article history

Published Online:

March 06 2009

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Citation

G. M. McAndrew, D. Ogston, Audrey A. Dawson; An Evaluation of Sternal Tenderness as a Sign of Leukaemia. Acta Haematol 1 May 1970; 43 (5): 309–312. https://doi.org/10.1159/000208742

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