Sternal foramen- Incidence and medico-legal importance

Sternum foramen may be misinterpreted as acquired lesions such as gunshot wound, fracture, lytic lesions, etc. Sternal foramen leaves the lung, heart and large vessels unprotected while performing invasive procedures such as bone marrow aspiration, acupuncture leading to life-threatening complications such as pneumothorax and cardiac tamponade. From a medicolegal perspective, identifying the morphological anomalies or variations of xiphoid process aid in the individualization process by serving as points of similarity when their occurrence has been recorded antemortem. In addition, their antemortem records in the form of previous x rays make important data for skeletonized remains to be identified.The present study was carried using sternal bones removed during autopsy on a total of 350 cases above the age of 30 years and has established aincidence of 6.57% for sternal foramen.Forensic pathologists should be meticulous enough to rule out errors in determining the nature and cause of death in worrying cases as sternal foramen is highly likely to be confused with gun-shot wounds or traumatic antemortem injury.