Xiphoid Process Anatomy and Clinical Significance

Anatomy and Diagnostic Approach

The xiphoid process is the most inferior portion of the sternum, located in the epigastric region between the sternal body and the umbilicus, with significant anatomical variations 1, 2
Plain radiographs are recommended as the first imaging step for any new soft tissue mass to identify bone involvement, according to the American College of Radiology 3
Ultrasound can be used as a primary triage tool after radiographs, with high sensitivity (94.1%) and specificity (99.7%) for evaluating superficial soft tissue masses, as suggested by the American Institute of Ultrasound in Medicine 3
During ultrasound examination of the abdominal aorta, the xiphoid process serves as an important anatomical landmark but should not be confused with pathology, as noted by the American College of Emergency Physicians 1, 2

MRI without IV contrast may be appropriate if soft tissue pathology is suspected and ultrasound is non-diagnostic, as recommended by the American College of Radiology 4, 5