A case-control study evaluating CT signs of xiphoid process associated with xiphodynia

TL;DR

This study found that CT signs of the xiphoid process are not reliable for diagnosing xiphodynia, as no significant differences were observed between patients with xiphodynia and those with other pain causes.

Contribution

The study provides new evidence that the xiphisternal angle and soft tissue compression are not useful diagnostic markers for xiphodynia.

Findings

No significant differences were found in xiphisternal angle, soft tissue compression, or xiphoid tip features between xiphodynia and control groups.

About 70% of cases showed a forward and backward curvature of the xiphoid process, regardless of the condition.

The xiphisternal angle is not a reliable marker for diagnosing xiphodynia.

Abstract

This study assessed whether CT signs of the xiphoid process, such as the xiphisternal angle and soft tissue compression, are useful for diagnosing xiphodynia. Conducted as a case-control study within a cohort, it involved 1560 participants who visited a small urban hospital in Japan for chest or abdominal pain between January 2021 and September 2023. From this group, patients who underwent CT scans that included the xiphoid process were selected. The study group consisted of nine individuals diagnosed with xiphodynia, while the control group included 321 individuals diagnosed with other causes of pain. No significant differences were found in the xiphisternal angle, soft tissue compression, or xiphoid tip features between the groups. However, in about 70% of cases, the xiphoid process curved forward and then backward. These findings suggest that the xiphisternal angle is not a useful marker for diagnosing xiphodynia, and that the curvature of the xiphoid process is common regardless of the condition.

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