The manubrium (from the Latin manubrium, meaning handle) constitutes a part of the sternum, bone belonging to the structure of the rib cage.

Position. The manubrium is one of the three parts of the sternum (manubrium, body, xiphoid process). Part of the rib cage, the sternum is a long, flat bone located in the front and center1,2. Triangular in appearance, the manubrium is located at the level of the thoracic vertebrae T3 and T4.

Structure. The manubrium is the widest and thickest part of the sternum. It is made up of different parts (2):

• The jugular notch, located in the center of its upper edge, is easily palpable at the base of the neck.
• The clavicular incisions, located on either side of the jugular incision, serve as attachment points to the clavicles to form the sterno-clavicular joints.
• The sternocostal synchondrosis of the 1st rib, located below and on either side of the clavicular incisures, constitutes the point of fusion of the first costal cartilages.
• The lower part of the manubrium connects with the body of the sternum to form the manubriosternal joint. These two structures are not positioned on the same plane, bringing the joint forward and forming the sternal angle.

Junction and mobility area. The manubrium plays an essential role in the mobility of the thorax by serving as an attachment point for the collarbones and the first ribs.

Thoracic trauma. It corresponds to damage to the thoracic cage due to shock to the thorax (3). Like other parts of the sternum, the manubrium can then be fractured.

Deformities of the chest wall. The chest wall can undergo certain deformities. We distinguish in particular:

• The thorax funneled, causing a hollow deformation, which is due to a projection behind the sternum (5).
• The thorax keeled, causing a bump deformity, which is due to the forward projection of the sternum (5) (6).

Tumors of the chest wall. Primary or secondary tumors can develop in the bones and especially in the manubrium (7) (8).

Arthritis. This pathology constitutes inflammation in the joints. It can affect the manubrium, and more specifically the sternoclavicular joint.

Medical treatment. Depending on the trauma or the pathology diagnosed, certain medications may be prescribed such as pain relievers and anti-inflammatory drugs.

Surgical treatment. Surgery may be performed for chest wall deformities, chest trauma, as well as for tumors (5) (7) (8).

Physical examination. First, the diagnosis begins with a physical examination to assess the symptoms perceived by the patient.

Medical imaging exams. Depending on the suspected or proven pathology, additional examinations may be performed such as an x-ray, an ultrasound, a CT scan, an MRI or a scintigraphy (3).

Chest compression. Used today as a first aid procedure, chest compression was first described in animals in 18749 before being demonstrated in humans in 1960 (10).