Sternal Foramen Simulating Osteolytic Lesion on Scintigraphy and SPET Imaging

Received 10/14/2002; accepted 10/29/2002. For correspondence or reprints contact: Michel De Maeseneer M.D., Ph.D., Department of Radiology, Free University Brussels, Laerbeeklaan 101, 1090 Jette, Brussels, Belgium. Tel: (32)2-4775320, Fax: (32)2-4775296, E-mail: [email protected] We present a 34-year-old man with pain at the level of the anterior chest wall. A lesion of the rib or rib cartilage was initially suspected. Bone scintigraphy using Tcmedronate was performed including single photon emission tomography (SPET). A well-delineated rounded area devoid of radioactivity was evident at the level of the sternal body. The possibility of an osteolytic lesion or an anatomic variation was considered and radiographs and X-ray computed tomography (CT) images of the involved region were performed. Radiography and CT confirmed the presence of a large bony defect at the level of the sternal body. Knowledge of the existence of such anatomic variants is important to avoid misdiagnosis as an osteolytic process. The possibility of a sternal foramen should be mentioned to the clinician because infiltration, biopsy or acupuncture of this area may lead to fatal cardiac complications.