ABSTRACT
A 14-year-old boy with no significant past medical history is referred to you for assessment of a chest wall depression. The patient and parents started noticing the deformity approximately 1 year previously and it seems to have advanced rapidly over the previous 6 months. There is no history of chest wall anomalies in the older siblings, parents, or other family members. The patient is not very athletic, but feels like he becomes short of breath when he runs or rides his bicycle uphill. He is somewhat withdrawn during the visit and is very self-conscious about removing his shirt for the examination. Once he removes his shirt, you discover the anomaly seen in Figure 6.1.
