Manubrium

The manubrium is the upper part of the breastbone (sternum). It sits in the center of your chest, where the collarbones (clavicles) and first ribs meet. When a radiology report mentions the manubrium, it usually refers to what your imaging showed in this area—normal anatomy, age-related changes, inflammation, trauma, or, less commonly, a growth or infection. This guide explains what the manubrium is, how it’s imaged, and what common report phrases mean in plain language.

Where the Manubrium Is and Why It Matters

• Location: Top segment of the sternum, just below the notch you can feel at the base of the neck (the “suprasternal” or jugular notch).

• Connections: Joins with both collarbones at the sternoclavicular joints and with the first rib cartilages; meets the rest of the sternum at the manubriosternal joint (also called the sternal angle).

• Function: Forms part of the chest wall that protects the heart, great vessels, and upper lungs; provides sturdy attachment points for ribs and shoulder girdle.

How the Manubrium Is Imaged

Chest X-ray (Radiograph)

• What it shows: Overall shape and alignment of the sternum and adjacent joints.

• Limits: Overlapping ribs, lungs, and heart can hide detail. The manubrium is often better assessed with a lateral sternal view or advanced imaging when a specific problem is suspected.

CT Scan (Computed Tomography)

• Strengths: Best for bone detail. CT reveals small fracture lines, subtle cortical breaks, tiny bone fragments, and calcifications.

• When used: Chest trauma, post-surgical evaluation (e.g., after heart surgery), suspected infection or tumor, or to clarify something seen on X-ray.

• What reports say: “Cortical irregularity,” “lucency,” “displacement,” “healing callus,” or “no acute osseous abnormality.”

MRI (Magnetic Resonance Imaging)

• Strengths: Shows bone marrow, cartilage, ligaments, and soft tissues.

• When used: Concern for bone marrow edema from stress injury, osteomyelitis (bone infection), arthritis at the manubriosternal or sternoclavicular joints, or to characterize a mass.

• What reports say: “Marrow edema,” “synovitis,” “joint effusion,” “enhancement,” or “no suspicious soft-tissue component.”

Ultrasound

• Strengths: Real-time, no radiation. Can detect cortical step-offs in fractures near the surface and evaluate sternoclavicular joint inflammation.

• Limits: Bone blocks deep views; less comprehensive than CT/MRI.

Common Manubrium Findings on Reports

1) Trauma and Fracture

• What it is: A break in the manubrium from direct impact or sudden deceleration (e.g., motor vehicle collision).

• How it looks: On CT, a thin lucent line through the bone cortex; sometimes a small step or gap.

• What you might read: “Nondisplaced manubrial fracture,” “manubrial body junction fracture,” or “no evidence of sternal fracture.”

• What it means for you: Stable, nondisplaced fractures often heal with pain control and rest; displaced or complex fractures may need closer follow-up.

2) Arthritis at the Joints

• Manubriosternal joint: Where the manubrium meets the sternal body (the “sternal angle”).

• Sternoclavicular joints: Where collarbones meet the manubrium.

• How it looks: Joint space narrowing, osteophytes (bony spurs), subchondral sclerosis (denser bone), or small cysts on CT; inflammation and fluid on MRI.

• What you might read: “Degenerative changes,” “osteoarthritis,” “hypertrophic changes,” or “erosions” (with certain inflammatory arthritides).

• Symptoms: Localized tenderness, swelling at the sternoclavicular area, or pain with shoulder motion or deep breaths.

3) Infection (Osteomyelitis) or Inflammation

• When suspected: Fever, pain, redness, or after surgery/central lines; also in certain systemic infections.

• Imaging clues: On MRI, marrow edema and enhancement; on CT, periosteal reaction, small gas pockets, or bone erosion in advanced cases.

• What reports say: “Findings concerning for osteomyelitis,” “phlegmon,” or “abscess”

4) Tumors and Metastases

• Benign: Bone islands (enostoses), hemangiomas—often incidental.

• Malignant: Metastatic disease (from lung, breast, thyroid, kidney, prostate), myeloma, or primary bone tumors—less common.

• Imaging: CT shows lytic (bone-destroying) or sclerotic (bone-forming) changes; MRI characterizes marrow involvement; PET/CT may assess metabolic activity.

• Report language: “Indeterminate sternal lesion—recommend MRI,” or “sclerotic focus likely benign bone island.”

5) Variants and Post-Surgical Changes

• Normal variants: Small sternal foramina (holes), unusual ossification patterns, subtle asymmetry at the manubriosternal junction.

• After surgery: Sternal wires, plates, or scars can produce streaks on CT and lines on X-ray.

• Usually benign: Your radiologist will label common variants as “no clinical significance.”

Manubrium Symptoms vs Imaging Findings

• Pain or tenderness over the upper sternum can come from joints, muscles, cartilage, or bone. Imaging helps sort out the source.

• Clicking or swelling at the sternoclavicular area often points to joint issues; MRI or ultrasound can show inflammation.

• Breathing pain after trauma raises suspicion for fracture—CT is most accurate for bone injury.

Phrases You May See in Your Report (and Plain-English Translations)

• “No acute osseous abnormality.” No bone injury seen.

• “Nondisplaced fracture of the manubrium.” A crack without a gap; bone alignment is preserved.

• “Degenerative change at the manubriosternal joint.” Wear-and-tear arthritis at the junction with the sternal body.

• “Marrow edema within the manubrium.” Swelling inside the bone on MRI, seen with bruising, stress injury, inflammation, or infection.

• “Indeterminate sternal lesion—recommend MRI.” A small spot needs a closer look; MRI helps decide if it’s benign or something that needs treatment.

When More Imaging or Follow-Up Is Suggested

Your radiologist may recommend:

• Targeted CT if X-ray is unclear and a fracture is suspected.

• MRI if there’s concern for marrow injury, infection, or to evaluate a mass.

• Repeat imaging to confirm healing or stability.
  These recommendations are routine and help your care team decide on the next steps.

How to Prepare and What to Tell Your Doctor

• Share symptoms and timing: Pain after an accident vs gradual soreness matters.

• List surgeries, devices, or infections: Heart surgery, lines, or recent infections can affect the sternum.

• Bring prior imaging: Old scans help confirm whether a finding is new or long-standing.

Conclusion
Mentions of the manubrium on your radiology report point to the top section of your breastbone and the joints that connect your chest and shoulders. Most findings are routine—age-related changes, stable variants, or clearly treated injuries. When something needs more evaluation, your radiology team will recommend the most informative test, typically CT for bone detail or MRI for soft tissues and marrow. Use the phrases in your report as a guide, and follow up with your doctor if symptoms persist or if additional imaging is needed.

References

https://radiopaedia.org/articles/manubrium?lang=us

https://www.ncbi.nlm.nih.gov/books/NBK541141/

https://teachmeanatomy.info/upper-limb/joints/sternoclavicular/