Sternalis Syndrome is an unusual cause of chest wall pain.  It is a myofascial pain syndrome, a painful condition of muscles of the chest wall.  The pain is located around the sternum and may radiate into the arm.  The pain is described as mild to moderate and is dull or aching.  The diagnosis of sternalis syndrome is made by eliciting trigger points in the muscles of the chest wall by palpation.  Sternalis syndrome is often confused with the pain of a heart attack and evaluation of the cardiac system is necessary to exclude this cause.  Other causes of chest wall pain, including trauma, pulmonary disease, fractures and neuropathic pain such as shingles must be excluded.  The work-up of sternalis syndrome includes those studies that exclude the other more common causes of pain and may include an EKG, chest X-ray and MRI of the chest and abdomen.  Treatment of sternalis syndrome is the same as for all other myofascial pain.  This includes rest, alternation in activities to limit pain, physical therapy, heat, ice, non-steroidal anti-inflammatory medications and acetominophen.  The painful trigger points can be injected with a dilute solution of a local anesthetic and may greatly decrease the painful symptoms.