# Xiphodynia: A Case of Post-traumatic Sternal Pain Managed With Bipolar Pulsed Radiofrequency

## TL;DR

A rare chest pain condition called xiphodynia was successfully treated with a specialized radiofrequency technique after failing other treatments.

## Contribution

Demonstrates the effectiveness of bipolar pulsed radiofrequency for treating refractory xiphodynia.

## Key findings

- Xiphoid process was confirmed as the pain source via lidocaine infiltration.
- Bipolar pulsed radiofrequency provided substantial and sustained pain relief.
- Xiphodynia should be considered in the differential diagnosis for persistent chest pain.

## Abstract

Xiphodynia is a rare, under-recognized musculoskeletal pain syndrome often misdiagnosed due to its nonspecific symptoms. We report a case of a 32-year-old male with chronic sternal pain following trauma, refractory to multiple conservative treatments and local anesthetic infiltration. Clinical evaluation revealed focal tenderness over the xiphoid process, with pain reproduced on palpation and bilateral anterior thoracic radiation. A transient diagnostic infiltration with 2 mL of 1% lidocaine confirmed the xiphoid process as the source of pain. The patient underwent ultrasound-guided bipolar pulsed radiofrequency (pRF) targeting the xiphoid process, resulting in substantial and sustained pain relief. This case highlights the importance of including xiphodynia in the differential diagnosis of persistent chest pain and demonstrates that pRF may be an effective option for refractory cases.