Anatomical Variant of Upper Humerus Notch in a Pediatric Case

When a medical image is requested for a particular indication, and a bony lesion is seen in a child, it causes anxiety to caregivers, unnecessary imaging costs, and unneeded biopsy. We present a complicated course of a five-month-old child who initially presented to the emergency room for prolonged cough and underwent a chest x-ray demonstrating clear lungs; however, a right humerus lytic lesion was identified. The child underwent multiple diagnostic imaging work-ups, which revealed a normal bone variation. This case report will describe a benign upper humeral notch variant with the goal to familiarize radiologists and clinicians with this entity and encourage them to obtain contralateral view radiographs to confirm bilaterality, prevent unnecessary advanced imaging as well added cost and anxiety to the parents.