Why does my sternum hurt when I move it?

If you are not careful at work, your body will be hit by heavy objects. Although this is inevitable, you must be careful. If you hit the sternum, it will be very painful. If you feel pain when your chest moves, you can go to the hospital for an X-ray to see if the sternum is fractured. The sternum is connected to the costal cartilage. If these bones feel uncomfortable, "referred pain" will occur. You can massage yourself or apply hot water. Let me tell you what is going on.

The sternum is a long flat bone, wide at the top and narrow at the bottom, located subcutaneously in the middle of the anterior wall of the thorax. The upper part and both sides of the sternum are connected to the clavicle and the upper 7 pairs of costal cartilages. The natural position of the sternum in the human body is approximately frontal, slightly slanted forward and downward, slightly convex in the front and concave in the back. From top to bottom, it consists of three parts: the manubrium, the body of the sternum, and the xiphoid process, which are connected to each other by cartilage.

1. Overview:

There are three notches on the upper edge of the manubrium, with a shallow and wide jugular notch in the middle; there are clavicular notches with oval articular surfaces facing backward and upward on both sides, forming a joint with the sternal end of the clavicle. There are 7 pairs of costal notches on the lateral edges of the manubrium and body of the sternum, which are connected to the 1st to 7th pairs of costal cartilages respectively.

The deformity of a protruding sternum is called "pigeon chest", and the deformity of a sunken sternum is called "funnel chest". Both of these deformities are generally caused by a lack of vitamin D and calcium. In clinical practice, puncture is sometimes used to obtain sternal bone marrow for examination.

2. Related diseases and treatment

1. Sternum fracture is caused by strong force acting directly on the sternum, such as car collision, heavy object crush, blunt object blow, and violent flexion of the spine. Sternum fracture can also occur. Simple sternum fractures are not fatal, and the serious adverse consequences are mainly caused by serious associated injuries. Violence acting on the front chest often causes serious chest organ damage such as contusion and laceration of the heart and large blood vessels, multiple rib fractures, lung contusion and laceration, bronchial rupture, and even abdominal organ damage, which can easily lead to serious life-threatening complications such as hemorrhagic shock, flail chest, respiratory and circulatory dysfunction, etc. Therefore, the diagnosis and emergency treatment of combined injuries are very important. First, life-threatening concurrent injuries such as hemorrhagic shock, cardiac tamponade, tension pneumothorax, active hemothorax, and cranial, brain, and abdominal organ injuries should be treated. After the condition stabilizes, consider treating sternal fractures.

2. The most common site of sternal fracture is sternal body fracture, accounting for about 76.5%, followed by sternal manubrium fracture, accounting for about 9%, and fracture at the junction of sternal manubrium and body accounting for about 8.5%.

3. Inspection method:

3.1 Chest X-ray examination: It is the preferred imaging examination method for diagnosing sternal fractures. Sternal fractures often undergo lateral and oblique displacement, and can be diagnosed through lateral and posteroanterior oblique plain films. However, plain films have a low detection rate for linear fractures without displacement of the broken ends and incomplete fractures, and have strict requirements on body position. Severely injured patients are often unable to cooperate with standard body position examinations due to pain or severe complex injuries, which affects the image quality and diagnostic accuracy and easily leads to missed diagnosis.

3.2 Ultrasound examination: Ultrasound diagnosis of sternal fractures has high sensitivity and specificity. It can accurately observe fine fracture lines and detect some combined chest injuries, such as mediastinal hematoma and pleural effusion. It is suitable for intensive care units and emergency rooms. However, ultrasound is not accurate in judging the degree of fracture displacement, and the observation of changes in the lungs, thoracic and lumbar spine and ribs is also limited, thus limiting its further application.