The xiphosternal joint is a secondary cartilaginous joint (synchondrosis) between the xiphoid process and the body of the sternum, which typically ossifies after the age of 40.
Provides attachment for the linea alba and rectus abdominis inferiorly, forms the inferior sternal reference for cardiac resuscitation and midline abdominal incision, and acts as the lower anchor for the anterior thoracic cage.
The xiphoid process can be fractured or displaced by incorrect CPR hand placement (too low), producing xiphosternal joint injury. In median sternotomy, the incision extends to the xiphoid — the joint is divided or the xiphoid removed to complete the sternotomy. Xiphoid syndrome (xiphodinia) produces localised pain reproduced by pressure on the xiphoid process.
Xiphoid process fracture or xiphosternal joint disruption from incorrect or excessive CPR hand placement, producing anterior chest pain after resuscitation.
Chronic pain at the xiphosternal joint from repetitive microtrauma or hypermobility of the xiphoid, reproduced by direct pressure, treated by local injection or xiphoid excision.
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