Sharp pain in sternum

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Sharp Pain in Sternum: Causes and Considerations

Sternal Stress Fracture in Athletes

Sternal stress fractures are a notable cause of sharp pain in the sternum, particularly in athletes who engage in repetitive upper-body exercises. This condition is often underdiagnosed but should be considered in the differential diagnosis of acute chest pain in athletes. Clinical examination supported by radiographs or isotope bone scans can aid in diagnosing this injury . The repetitive stress on the sternum from activities such as wrestling or other high-impact sports can lead to these fractures, presenting as acute anterior chest pain .

Sternocostoclavicular Hyperostosis

Sternocostoclavicular hyperostosis is another condition that can cause persistent, pulling pain in the sternum, clavicles, and upper ribs. This pain is often exacerbated by cold and damp conditions. Patients with this condition may exhibit symmetrical enlargement of the clavicles, venous congestion, and elevated erythrocyte sedimentation rates. Radiological findings include symmetrical hyperostosis of the clavicles and sternum, synostosis of the sternoclavicular joints, and involvement of the upper ribs. The exact cause of this condition remains unknown, but it is characterized by hyperostotic sclerosis of the spongiosa in the clavicles.

Sternal Wire Sutures Post-Surgery

Sternal wire sutures used in median sternotomy can also lead to sharp, stabbing chest pain. This pain can occur months to years after surgery and is often due to an exaggerated fibrous tissue reaction around the twisted portion of the wires. In some cases, sensory nerve fibers become entrapped, leading to significant pain and tenderness. Removal of the involved wires and surrounding fibrous tissue can relieve these symptoms.

Conclusion

Sharp pain in the sternum can arise from various conditions, including sternal stress fractures, sternocostoclavicular hyperostosis, and complications from sternal wire sutures post-surgery. Accurate diagnosis through clinical examination and imaging is crucial for effective treatment and pain relief. Understanding these potential causes can help in managing and alleviating sternum pain effectively.