Sternal foramen (or perforated sternum) is an oval foramen present at lower one-third of the sternum. It is a relatively common anatomical variation found in 2.5% to 13.8% of individuals.[1]
This variation is usually present at the lower one-third of the sternal body. It has an oval shape and a unique "bow tie" appearance when seen on axial computed tomography. The diameter of the sternal foramen ranges from 6 to 16 mm with an average diameter of 6.5 mm.[2] Sometimes, the foramen can be present at the xiphod process. In extremely rare cases, the foramen is found at the manubrium.[3]
Developmentally, sternal foramen results from the incomplete fusion of the sternal bars while they are still cartilaginous.[4]
Although sternal foramen is asymptomatic, it may entail a risk of serious complications from blinded sternal interventions. The foramen may be misdiagnosed as sternal fracture or a gunshot wound. Awareness of sternal foramen is also crucial in acupuncture to avoid cardiac tamponade.[5]
