Aguiar André, Carrillo-Alfonso Noélia, Eliseu Afonso, Segundo Ana Catarina, Lares Ana
Anesthesiology, Unidade Local de Saúde do Algarve - Hospital de Faro, Faro, PRT.
Cureus. 2025 Jun 12;17(6):e85853. doi: 10.7759/cureus.85853. eCollection 2025 Jun.
Xiphodynia is a rare, under-recognized musculoskeletal pain syndrome often misdiagnosed due to its nonspecific symptoms. We report a case of a 32-year-old male with chronic sternal pain following trauma, refractory to multiple conservative treatments and local anesthetic infiltration. Clinical evaluation revealed focal tenderness over the xiphoid process, with pain reproduced on palpation and bilateral anterior thoracic radiation. A transient diagnostic infiltration with 2 mL of 1% lidocaine confirmed the xiphoid process as the source of pain. The patient underwent ultrasound-guided bipolar pulsed radiofrequency (pRF) targeting the xiphoid process, resulting in substantial and sustained pain relief. This case highlights the importance of including xiphodynia in the differential diagnosis of persistent chest pain and demonstrates that pRF may be an effective option for refractory cases.
剑突痛是一种罕见的、未得到充分认识的肌肉骨骼疼痛综合征，因其症状不具特异性，常被误诊。我们报告一例32岁男性病例，该患者外伤后出现慢性胸痛，经多种保守治疗及局部麻醉药浸润均无效。临床评估发现剑突处有局部压痛，触诊时疼痛再现，并向双侧胸前区放射。用2毫升1%利多卡因进行的短暂诊断性浸润证实剑突是疼痛来源。患者接受了超声引导下针对剑突的双极脉冲射频治疗（pRF），疼痛得到显著且持续的缓解。该病例强调了在持续性胸痛的鉴别诊断中纳入剑突痛的重要性，并表明pRF可能是治疗难治性病例的有效选择。
