Supraclavicular depressions, particularly if unequal or unilateral, are generally regarded as suggestive evidence of tuberculous disease at the apex of the lung. In the recent classification of pulmonary tuberculosis adopted by the American Sanatorium Association,1 a slight depression above the clavicle is mentioned among the physical signs of early or minimal tuberculosis. In attempts to estimate the value of this sign, however, observers apparently have failed to recognize the significance of similar depressions occurring in healthy persons. This is an important fact to establish, because the relative value of a sign in disease is decreased proportionately with the frequency of its occurrence in health. With this point in mind, we made a comparative study of the incidence, distribution and depth of the supraclavicular depressions in 153 healthy adults and 150 patients with incipient pulmonary tuberculosis.
At the same time, an attempt was made to discover methods of differentiating the
H. A. BRAY, A. H. DUERSCHNER. SUPRACLAVICULAR DEPRESSIONS IN THE DIAGNOSIS OF EARLY PULMONARY TUBERCULOSIS. JAMA. 1923;80(23):1670–1674. doi:10.1001/jama.1923.02640500012005