April 1978

Rhomboid Fossa or Inflammation?

Author Affiliations

Torrance, Calif

Arch Intern Med. 1978;138(4):658-659. doi:10.1001/archinte.1978.03630280102036

To the Editor.—  I would like to call attention to a very frequent normal finding on roentgenograms of the clavicle, which is frequently interpreted as pathologic change and may result in inappropriate biopsy. It concerns case 1 of the otherwise very excellent article by Bayer et al, entitled "Sternoclavicular Pyoarthrosis Due to Gram-Negative Bacilli: Report of Eight Cases," in the August 1977 issue of Archives (137:1036-1040). Figure 1 reveals an erosion of the sternal articular surface of the clavicle, which is certainly inflammatory in origin. However, separated from it by 1 to 2 cm, along the inferior margin of the medial shaft, is a broad-based, shallow defect with sclerotic margins. This is stated to be another erosion.In fact, however, the more lateral of these two defects is actually a very common structure that is well known to most radiologists. It actually represents a fossa at the attachment of the

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