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

Abstract

AbstractObjectivesTo investigate whether CT signs of the xiphoid process, such as xiphisternal angle and evidence of soft tissue compression, are useful for diagnosing xiphodynia.DesignA case-control study within a cohort.Setting/ParticipantsParticipants 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.InterventionsThe 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.ResultsThere 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.ConclusionsThe 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.