The costoxiphoid ligaments are small fibrous bands connecting the anterior and posterior surfaces of the seventh costal cartilage to the corresponding surfaces of the xiphoid process. They help fix the xiphoid to the lower margin of the anterior thoracic cage, where the rectus abdominis, linea alba and diaphragm all gain attachment.
| Origin | Anterior and posterior surfaces of the seventh costal cartilage (sometimes also the sixth) |
|---|---|
| Insertion | Anterior and posterior surfaces of the xiphoid process |
Anchors the xiphoid process to the lower costal cartilages, steadying it against the pull of the abdominal wall and diaphragm.
Irritation or sprain of the costoxiphoid ligaments is thought to contribute to xiphodynia (xiphoid syndrome), a cause of localised anterior chest or epigastric pain reproduced by pressing on the xiphoid. The condition can mimic cardiac, gastric or gallbladder pain, so other causes are usually excluded first. Management is mainly conservative with activity modification, anti-inflammatory measures and local injection in persistent cases.
Localised tenderness and pain over the xiphoid process and its costoxiphoid attachments, often aggravated by bending, heavy meals or direct pressure.
Strain of the costoxiphoid ligaments after blunt trauma or forceful trunk movement, producing focal pain at the lower sternum that eases over several weeks.
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