Erosion of the inferior aspect of the clavicle in secondary hyperparathyroidism.

Erosion of the inferior aspect of the outer third of the clavicle has been found on chest films in 19 out of 100 randomly selected azotemic patients. This important manifestation of secondary hyperparathyroidism compares favorably with other sites of clavicular erosion. Its frequency and degree increase with length of time on dialysis. A review of the local anatomy and of the mechanical stresses imposed on the coracoclavicular ligament explains why anteroposterior and portable chest films are particularly well suited for early detection of these changes.