Xiphisternal Joint

symphysis xiphosternalis

The xiphisternal joint is a fibrocartilaginous union between the xiphoid process and the inferior end of the sternal body. It typically ossifies after age 40, becoming a bony fusion in most adults. The xiphisternal junction is a palpable landmark in the epigastric region and marks the attachment of the diaphragm and the inferior limit of the pericardium.

Region: Chest

Clinical Relevance

Clinical Notes

The xiphisternal junction is a surface landmark for the upper border of the liver, the inferior limit of the heart, and the correct hand position for chest compressions during CPR (the compression point is two finger-breadths above this junction). The xiphoid process itself can be fractured during overly aggressive CPR or blunt epigastric trauma, occasionally causing xiphoidalgia, a syndrome of chronic anterior chest pain exacerbated by eating and posture. A bifid xiphoid process is a common anatomical variant.

Pathology

Common Injuries & Conditions

Xiphoidalgia

Chronic pain and tenderness at the xiphoid process, often following direct trauma or after CPR, producing epigastric discomfort that may mimic cardiac or gastrointestinal symptoms and is diagnosed by direct palpation reproducing the pain.

Xiphoid Fracture

Fracture from blunt chest trauma or CPR is usually clinically silent but can be visible on CT; very rarely a displaced fragment causes symptoms requiring surgical excision of the xiphoid process.