The suprasternal fossa on chest radiographs in newborns

Visualization of the suprasternal fossa in the newborn is due to suprasternal retraction. It is seen in 59% of patients with respiratory distress syndrome of the premature prior to intubation, and in 5% of patients with conditions such as pneumonia, meconium aspiration, and transient tachypnea of the newborn. The lower compliance of the lungs in patients with respiratory distress syndrome and increased compliance of the chest wall in premature infants accounts for the higher incidence of accentuation of the fossa. Visualization of the suprasternal fossa can simulate the distended proximal pouch of esophageal atresia. The two can be differentiated in the lateral view where the pretracheal location of the fossa can be appreciated.
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