The rhomboid fossa in Turkish children: a comprehensive analysis of chest CT

Abstract

Objective: This study aims to determine the incidence, dimensions and side distribution of excavated-type rhomboid fossa (RF) in the Turkish pediatric population. Methods: Thoracic computed tomography scans of a total of 5985 pediatric patients performed between January 2016 and July 2024 were evaluated retrospectively. The presence of RF was evaluated by consensus by two radiologists on axial, coronal, and sagittal sections obtained in bone window settings. Size measurements were taken on coronal sections for transverse and craniocaudal diameters, and on sagittal sections for anteroposterior diameters. For statistical analysis, gender distribution was evaluated with the chi-square test, and size differences between sides were evaluated with an independent and paired t-tests. P < 0.05 was considered significant. Results: The excavated type RF was detected in 2.77% (166 patients 124 men, 42 women). It was significantly more common in men (P < 0.001). RF was most frequently seen bilaterally (56%), followed by the right side (25%) and the left side (19%) (P < 0.001). In bilateral cases, although there was no significant difference in the transverse dimension between the right and left diameters (P = 0.572), the anteroposterior (P = 0.042) and craniocaudal diameters (P = 0.018) were found to be significantly larger on the right side. In all patients, the anteroposterior (P = 0.034) and craniocaudal (P = 0.025) diameters of the right RF were significantly larger than the left RF. It was also shown that larger RFs were significantly associated with bilateral localization (P < 0.001). Conclusion: This study is the first to reveal the incidence of excavated type RF in the Turkish pediatric population. Findings show that RF occurs bilaterally and more frequently on the right side, and is significantly more common in men. Additionally, it has been found that the size of the RF may be an effective factor in bilateral localization. Our study shows that RF is a criterion that can be used to ascertain gender.