Purpose or Case Report: Pediatric sternal lesions encompass a broad constellation of diagnoses, many of which carry a high level of clinical significance. The purpose of this exhibit is to review sternal development and a diverse array of pediatric sternal lesions across multiple modalities in order to (1) assist the clinical radiologist in identifying these diagnoses, (2) highlight a class of entities (sternal lesions) which is easily overlooked, and (3) provide a simple and practical mental framework for categorizing these entities. This exhibit explores multi-modality imaging examples in a variety of interesting cases obtained through a retrospective review at a large quaternary care center. The relevant clinical features and key imaging findings for each diagnosis are discussed to educate radiologists and radiology residents, aiming to improve diagnosis and patient outcomes. Cases discussed include congenital variations in development (pectus excavatum and pectus carinatum), traumatic sternal fracture, neoplastic etiologies (SELSTOC, Ewing Sarcoma, B-Cell Acute Lymphoblastic Leukemia, and metastatic disease), as well as infectious/inflammatory presentations (sternal osteomyelitis, abscess, and chronic recurrent multifocal osteomyelitis).
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