Presentation
Asymptomatic young male, tall and extremely physically exercised, especially on the upper torso and limbs. Screening exam for joining the Armed Forces.
Patient Data
Both lung fields are unremarkable. Area of costophrenic angles clear (partially depicted here, due to height - checked with a secondary X-ray, not shown).
Cardiomediastinal contours and hilar regions within normal limits.
Mild scoliosis of the thoracic spine.
Incidental findings: prominent rhomboid fossa (of the excavated type) in the inferior surface of the sternal end of both clavicles - a normal variant.
Prominent rhomboid fossa (red curved lines on the annotated image).
Hypertrophy of soft tissue around the thorax, as an outcome of intense physical exercise (red arrows, lower left, and right).
Case Discussion
The presence of bilateral rhomboid fossae in an extremely physically exercised young male may be interpreted as an outcome of the mechanical theory of fossa formation due to applied pressure by costoclavicular ligament.