OBJECTIVE
The clavicle is almost always involved in skull X-rays of infants. The objectives of this study were to determine how often the clavicle and clavicle fractures are visible but missed on skull anterior-posterior view (skull AP) of infants and which factors are associated with missing the diagnosis. MATERIALS AND METHODS: We retrospectively studied about the patients aged 1 year or younger who were taken skull AP for any injury survey at a single urban, academic hospital from April 1999 to July 2012. Outcomes of interest were the numbers and percentage of visible clavicles, clavicle fractures including missed ones on skull AP, and the factors associated with a missing the diagnosis.
RESULTS
Both clavicles were visible in 734 patients (89.6%). Of them, 10 cases (1.4%) of clavicle fractures were confirmed and 6 of them (0.8%) were missed at presentation. Although we tried to determine the factors associated to missed diagnoses among age (< 6 months), male sex, blocking by guardian’s hands, associated skull fractures, mechanism of injury, none was significantly associated with clavicle fractures.
CONCLUSION
The clavicle was recognizable on skull X-rays in most cases. Therefore one should check the clavicle while reading skull X-rays.

Objective
The aim of the present study was to investigate the relation between shoulder position and subclavian central venous (SCV) catheter misplacement. The shoulder position was estimated using clavicular tilt angle (CTA) values observed on anteroposterior chest X-ray images.
Methods
A retrospective case-control study was conducted on all adult patients who underwent SCV catheterization in the emergency department during a 12-month period. Collected data included patient age, sex, diagnosis, catheterization side, catheter misplacement, and physician’s level of experience in catheterization. The CTA and other radiological variables such as the ipsilateral transverse length of the thorax and thickness of the clavicle were investigated. Results Among all central venous catheterizations (n=1,599), the subclavian route was used 981 times (61.4%). There were 51 misplacements of SCV catheters (5.2%) during the study period. There were no differences in the sex, age, blood pressure, and diagnosis between the two groups. The CTA values were 28.5°±7.3° and 22.6°±6.3° in the misplacement group and control group, respectively (95% confidence interval, 3.6 to 8.1; P<0.001).
Conclusion
In this study, the CTA was found to be 5.9° larger in the misplacement group than in the control group. Assuming that CTA indicates the shoulder position, our findings suggest that the chance of SCV catheter misplacement may be reduced by avoiding the shoulder elevated.