Unfused sternum as a rare cause of gradual onset chest pain – Case report

There is a wide range of orthopedic differential diagnoses for sternal pain. Incomplete development of the sternum, resulting in unfused sternebrae, may gradually become symptomatic after repetitive stress and can mimic a stress fracture. A symptomatic unfused sternum is a rare cause of sternal pain. A healthy young man presented with 3 years of chest wall pain with sudden onset. He performed physical labor on a fish farm and also worked as a gasfitter. Physical examination revealed mild pain when palpating the sternum. Conventional X-rays did not show any abnormalities. Subsequent bone scintigraphy and single-photon emission computer tomography (SPECT) revealed an unfused sternal body with an image similar to a sternal fracture, which was confirmed by conventional computer tomography (CT). To our knowledge, this is the first case describing complaints of a previously asymptomatic unfused sternum. Developmental disorders of the sternum should be considered in the differential diagnosis of chest wall pain, especially when there is habitual physical activity of the upper extremities.