Double sternal foramina in a dried sternum: a rare normal variant and its radiologic assessment

Sternal foramina (SF) constitute developmental defects of the sternum and are usually radiologic or postmortem accidental findings. A rare case is presented, concerning the dried sternum of Greek origin and unknown age. The manubrium, sternal body and xiphoid process were fused and ossified, while two SF of undocumented size were present. The proximal SF was located at the sternal body extending between the fourth and fifth intercostal spaces, whereas the distal SF was located at the xiphoid process being surrounded by a thin "ring-like" osseous rim. Computed tomography was utilized for further investigation. Awareness of this variation is essential for the radiologist to avoid misdiagnosis and interpret with accuracy the current combination of normal anatomic variants. Moreover, SF existence is associated with clinical and forensic implications that are shortly discussed.