A bursa at or near the xiphisternal junction, situated between the xiphoid process and overlying tissues. It can develop from direct pressure or repetitive epigastric trauma. The xiphisternal junction is also subject to hypermobility-related friction.
Xiphisternal bursitis presents as a discrete tender swelling at the tip of the sternum, which may be confused with a xiphoid process fracture, xiphodynia, or epigastric hernia. Ultrasound confirms the bursal nature of the swelling. Xiphoid excision may be required for refractory pain.
Pain syndrome at the xiphoid process from bursal inflammation or cartilaginous irritation, producing epigastric discomfort that worsens with bending and is reproduced by palpation of the xiphoid.
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