Pediatric Sternal Development: Analysis Using Postmortem Computed Tomography
Description
The sternum develops from a series of individual sternebrae that fuse during growth and development, which are subsequently joined by the manubrium and xiphoid process. Pediatric sternal development has been reported to be highly variable in sternebrae counts and fusion patterns. The aim of this research was to gain a better understanding of pediatric sternal development, including the effects of age and sex on fusion. Postmortem CT scans of 292 pediatric individuals (newborn to 21 years) were obtained from the New Mexico Decedent Image Database. Bony sternebrae counts and the presence of a manubrium, xiphoid process, and mesosternum (fusion of the manubrium to the first sternal vertebra) was recorded. ANCOVA and Kaplan-Meier tests were used to assess sex differences in ages of occurrence.
A manubrium was present in all individuals by birth. Up to seven sternebrae were observed throughout the ages. Some individuals retained at least two sternebrae through 16 years of age. An ossification center for the xiphoid process was observed as early as birth, though it was absent in individuals as old as 20.93 years. The earliest attainment of a mesosternum was 1.15 years. ANCOVA results, with age as a covariate, indicate sex differences in sternebrae counts with females on average having lower counts (p < 0.001). This is consistent with general patterns of earlier female skeletal development. No significant sex differences were observed in xiphoid ossification or mesoternum fusion (p > 0.05). Overall, the results support expected trends, yet illustrate the importance of pediatric clinicians understanding the high degree of sternal variation and factors that may influence its development.
Citation Information
Pichelmann, Sadie; Foix, Emilee; and Garvin, Heather, "Pediatric Sternal Development: Analysis Using Postmortem Computed Tomography" (2026). Office of Research DMU Research Symposium. 106.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/106
Pediatric Sternal Development: Analysis Using Postmortem Computed Tomography
The sternum develops from a series of individual sternebrae that fuse during growth and development, which are subsequently joined by the manubrium and xiphoid process. Pediatric sternal development has been reported to be highly variable in sternebrae counts and fusion patterns. The aim of this research was to gain a better understanding of pediatric sternal development, including the effects of age and sex on fusion. Postmortem CT scans of 292 pediatric individuals (newborn to 21 years) were obtained from the New Mexico Decedent Image Database. Bony sternebrae counts and the presence of a manubrium, xiphoid process, and mesosternum (fusion of the manubrium to the first sternal vertebra) was recorded. ANCOVA and Kaplan-Meier tests were used to assess sex differences in ages of occurrence.
A manubrium was present in all individuals by birth. Up to seven sternebrae were observed throughout the ages. Some individuals retained at least two sternebrae through 16 years of age. An ossification center for the xiphoid process was observed as early as birth, though it was absent in individuals as old as 20.93 years. The earliest attainment of a mesosternum was 1.15 years. ANCOVA results, with age as a covariate, indicate sex differences in sternebrae counts with females on average having lower counts (p < 0.001). This is consistent with general patterns of earlier female skeletal development. No significant sex differences were observed in xiphoid ossification or mesoternum fusion (p > 0.05). Overall, the results support expected trends, yet illustrate the importance of pediatric clinicians understanding the high degree of sternal variation and factors that may influence its development.
