What is the scientific name for xiphoid (breastbone) inflammation?

Xiphoidalgia: Scientific Name and Management

Xiphodynia is the scientific name for inflammation or pain of the xiphoid process (breastbone tip). 1

Clinical Understanding

Xiphodynia is a rare but potentially debilitating musculoskeletal condition characterized by pain originating from the xiphoid process. The pain can radiate to the chest, abdomen, throat, and arms, often mimicking other more serious conditions.

Key Features:

• Pain is typically reproduced with light pressure on the xiphoid process
• May present as epigastric or anterior chest pain
• Can be mistaken for cardiac, pulmonary, or gastrointestinal disorders

Etiology and Risk Factors

Several factors can contribute to the development of xiphodynia:

• Primary causes:

  • Anatomical variations (large or protruding xiphoid process) 2
  • Direct trauma to the xiphoid area
  • Repetitive compression (as seen in surfers) 3

• Secondary causes (associated conditions):

  • Gastroesophageal reflux disease (GERD)
  • Gallbladder disease
  • Angina pectoris
  • Coronary artery disease 1

Diagnostic Approach

Diagnosis is primarily clinical and involves:

1. Physical examination: Reproduction of pain with palpation of the xiphoid process
2. Imaging: CT scan may reveal xiphoid abnormalities (e.g., protrusion, enlargement) 2
3. Exclusion of other causes: Cardiac, pulmonary, and gastrointestinal conditions should be ruled out

Treatment Options

Treatment should follow a stepwise approach based on severity:

1. Conservative Management (First-line)

• Rest and activity modification
• Anti-inflammatory medications (NSAIDs)
• Physical therapy
• Heat or cold therapy

2. Interventional Approaches (Second-line)

• Local anesthetic and steroid injections
  • Limited to 5-7 mL of solution
  • Results may vary when multiple trigger points are present 4

3. Surgical Management (For refractory cases)

• Xiphoidectomy (surgical removal of the xiphoid process)
  • Indicated for severe, persistent pain unresponsive to conservative measures
  • Particularly effective for anatomical abnormalities like protruding xiphoid process 5, 3
  • Has shown good outcomes in cases of xiphoid process-induced pain 3

Clinical Pearls and Pitfalls

• Diagnostic challenge: Xiphodynia frequently mimics other conditions, leading to delayed diagnosis and treatment 1
• Examination technique: Light pressure on the xiphoid process that reproduces the patient's symptoms is a key diagnostic finding 4
• Treatment response: Many patients experience significant relief with local injections, though some may require surgical intervention 4
• Post-surgical outcomes: Patients who undergo xiphoidectomy can typically return to normal activities, including sports, within a few weeks 3

Follow-up Recommendations

• Monitor response to conservative treatment over 2-4 weeks
• Consider interventional approaches if pain persists
• Reserve surgical consultation for cases unresponsive to less invasive measures
• Post-treatment follow-up to ensure resolution of symptoms and address any complications

By understanding the proper diagnosis and management of xiphodynia, clinicians can provide effective relief for patients suffering from this uncommon but significant cause of chest and abdominal pain.