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Updated: Jan 15, 2026

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Sternal Foramina Detected by Postmortem Computed Tomography in the Japanese Population: Prevalence and Developmental

Akihito Usui1, Sonoka Sato1, Eiji Suzuki1

  • 1Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Radiology Research and Practice
|October 9, 2025
PubMed
Summary

Sternal foramina, often silent congenital anomalies, occur in 3.7% of adults and pose risks during sternal procedures. Pediatric ossification patterns suggest a developmental origin for these foramina, highlighting the need for awareness in imaging and planning.

Keywords:
foraminaforensic radiologypostmortem computed tomographysternal ossificationsternum

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Area of Science:

  • Anatomical studies
  • Developmental biology
  • Medical imaging

Background:

  • Sternal foramina are congenital anomalies from incomplete sternal fusion.
  • They are often asymptomatic but risk sternal procedures due to proximity to mediastinal structures.
  • Limited data exists on prevalence in Japanese populations and their developmental origins.

Purpose of the Study:

  • To investigate the development, prevalence, and anatomical characteristics of sternal foramina.
  • To analyze a large Japanese cohort using postmortem CT scans.
  • To explore developmental contributions to foramen formation.

Main Methods:

  • Retrospective review of postmortem CT scans from 1503 adults and 92 pediatric cases.
  • Assessment of adult sternal foramina prevalence, sex distribution, location, diameter, and adjacent structures.
  • Evaluation of pediatric sternebral ossification patterns to understand foramen development.

Main Results:

  • Sternal foramina were found in 3.7% of adults, more frequent in males (4.3%) than females (2.5%).
  • Most foramina were near the fifth costal notch, overlying vital structures in 72% of cases.
  • 12% of pediatric cases showed ossification patterns potentially leading to foramina, with an estimated 31% persisting into adulthood.

Conclusions:

  • Sternal foramina occur in 3.7% of adults, often over critical structures, posing procedural risks.
  • Pediatric ossification patterns (12%) suggest a developmental basis, with ~31% persisting into adulthood.
  • Recognition of sternal foramina is crucial for imaging and procedural planning due to their developmental origins and anatomical location.