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Radiology signs

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Radiology signs

  1. 1. Dr Tejas M Tamhane. JRII, DEPT. OF RADIO-DIAGNOSIS
  2. 2. To quote Dr. Neuffer “These are the things Radiologists come up with when they sit in the dark too long…”
  3. 3. AIR CRESCENT SIGN Sickle shaped lucency partly surrounding a mass in a pulmonary cavity on x ray and CT. Classically in ASPERGILLOMAS.
  4. 4. ANGEL WING OR BAT WING SIGN Seen in pulmonary edema which involves perihilar regions and spares cortex of the lung
  5. 5. ANTEATER’S NOSE SIGN On lateral view of foot, elongated anterior, superior process of calcaneous seen in tarsal coalition.
  6. 6. APPLE CORE SIGN Appearance of an annular constricting carcinoma of the bowel, usually the colon, from circumferential involvement of the lumen.
  7. 7. BAMBOO SPINE Undulating contour of spine caused by bridging syndesmophytes seen in ankylosing spondylitis.
  8. 8. BEVELED EDGE APPEARANCE Asymmetric erosion of the inner and outer tables of the skull usually seen with EOSINOPHILIC GRANULOMA.
  9. 9. BLADE OF GRASS SIGN Advancing wedge shaped, osteolytic margin of active Paget disease of bone. Seen in diaphysis. AKA FLAME SIGN.
  10. 10. BIRD OF PREY SIGN Tapered barium column seen in SIGMOID VOLVULUS
  11. 11. BIRD’S BEAK SIGN Irregularly marginated tapering of esophagus in ACHALASIA. AKA RAT TAIL SIGN.
  12. 12. BOWLER HAT SIGN Cup shaped filling defect seen on air contrast barium enema that represents POLYP if it points towards lumen.
  13. 13. BONE WITHIN BONE SIGN Inner layer of cortical new bone within an existing bone seen with OSTEOPETROSIS, SICKLE CELL DISEASE.
  14. 14. BOOT SHAPED HEART Typical shape of heart seen in TETRALOGY OF FALLOT. Includes:- 1.Pulmonary infundibular stenosis. 2.Overriding aorta. 3.VSD 4.RVH
  15. 15. BOX SHAPED HEART Squared off appearance of the heart in EBSTEIN’S ANOMALY due to large right atrium and dilated Rt. Ventricular outflow tract
  16. 16. BULGING FISSURE SIGN Bulging of usually minor fissure from heavy, exudative pneumonia like KLEBSIELLA.
  17. 17. BOUTONNIERE DEFORMITY Hyperextension of DIP Jt and flexion of PIP Jt seen in RHEUMATOID ARTHRITIS.
  18. 18. COLON CUT OFF SIGN Abrupt cutoff of colonic gas column at the splenic flexure (arrow). The colon is usually decompressed beyond this point. Seen in ACUTE PANCREATITIS
  19. 19. CARMAN MENISCUS SIGN Large gastric ulcer seen on UGI convex in towards the lumen of the stomach, rolled edges suggestive of malignancy
  20. 20. CODMAN TRIANGLE Triangular elevation of periosteum from an aggressive, usually malignant, bone tumor such as an OSTEOSARCOMA.
  21. 21. COTTON WOOL APPEARANCE Islands of poorly marginated sclerotic disease surrounded by less dense skull in PAGETS DISEASE.
  22. 22. COFFEE BEAN SIGN Dilated sigmoid colon in SIGMOID VOLVULUS thought to resemble giant coffee beans.
  23. 23. COBRA HEAD APPEARANCE Rounded dilatation of distal ureter, surrounded by thin lucent line, seen in pts with URETEROCELES.
  24. 24. COBBLESTONE APPEARANCE GI alternating normal and denuded mucosa from ulceration, esp in CROHN’S DISEASE OF COLON.
  25. 25. CHAMPAGNE GLASS SIGN Squaring of the iliac wings producing a champagne glass appearance of the pelvic inlet seen in ACHONDROPLASIA.
  26. 26. CRESCENT SIGN Caused by: LUQ Soft tissue mass OR Head of intussusception in distal transverse colon
  27. 27. CONTINUOUS DIAPHRAGM SIGN Visualisation of the entire upper surface of diaphragm from PNEUMOMEDIASTINUM
  28. 28. CORKSCREW ESOPHAGUS Constricted, twisted lumen from abnormal, tertiary contractions seen in DIFFUSE ESOPHAGEAL SPASM.
  29. 29. COCKADE SIGN Intraosseous calcaneal LIPOMA with central calcification resembling the badge generally worn upon a hat.
  30. 30. CODFISH VERTEBRA Biconcave appearance of vertebral bodies from avascular necrosis resembling vertebra of codfish. Seen in SICKLE CELL ANAEMIA.
  31. 31. DAVID LETTERMAN SIGN Widening of distance between the scaphoid and lunate >3mm on PA view from ligament disruption. AKA TERRY THOMAS SIGN
  32. 32. DOUBLE BUBBLE SIGN Dilated stomach and proximal duodenum in newborn, typically seen in DUODENAL ATRESIA, MIDGUT VOLVULUS OR ANNULAR PANCREAS.
  33. 33. DEEP SULCUS SIGN Inferiorly depressed costophrenic angle from PNEUMOTHORAX seen on supine radiograph of chest.
  34. 34. DROOPING LILY SIGN Appearance of lower pole calyces in a duplicated collecting system with non functioning of upper pole.
  35. 35. DRIPPING CANDLE WAX SIGN Cortical hyperostosis on one side of bone likened to melting wax, seen in MELORHEOSTOSIS.
  36. 36. DAGGER SIGN Dense line caused by ossification of supraspinous and interspinous ligaments in ANKYLOSING SPONDYLITIS
  37. 37. EGGSHELL CALCIFICATION Peripheral calcification of thoracic lymph nodes, most often seen in SILICOSIS but also can be seen in SARCOID.
  38. 38. EGG ON STRING SIGN Narrowing of superior mediastinum and globular shape of heart in neonates with TRANSPOSITION OF GREAT ARTERIES.
  39. 39. FALLEN FRAGMENT SIGN Small piece of bone settles to dependent portion of a UNICAMERAL BONE CYST from pathological fracture.
  40. 40. FIG 3 SIGN Seen in COARCTATION OF AORTA, dilated LSCA, indentation of coarct and post stenotic aortic dilatation form “3”
  41. 41. FOOTBALL SIGN Oval shaped lucency seen on supine abdominal radiographs in LARGE PNEUMOPERITON EUM usually in infants.
  42. 42. FISHOOKING OF URETER J shaped appearance of distal ureter from enlargement of prostate and elevation of trigone usually in BPH.
  43. 43. FISHMOUTHING OF VERTEBRA Biconcave appearance of the disc spaces in SICKLE CELL DISEASE from avascular necrosis of the vertebral endplates resembling fish mouth.
  44. 44. GOLDEN S SIGN S shape caused by edge of elevated minor fissure and hilar mass in RUL ATELECTASIS.
  45. 45. GLOVED FINGER SIGN Finger like projections from hilum from bronchial mucoid impaction in ALLERGIC BRONCHOPULMON ARY ASPERGILLOSIS OR ASTHMA.
  46. 46. GULL WING SIGN DIP jts showing central erosions and marginal osteophytes in EROSIVE OSTEOARTHRITIS.
  47. 47. HAIR ON END SIGN Spiculated appearance of elongated trabeculae in widened diploic space seen in HEMOLYTIC ANAEMIAS ESP THALASEMIA.
  48. 48. HEEL PAD SIGN Enlarged soft tissue of heel pad (>23mm) that might indicate presence of ACROMEGALY.
  49. 49. HONDA SIGN Characteristic H shape, similar to carmaker’s logo of bone radiotracer uptake in sacrum due to SACRAL INSUFFICIENCY FRACTURES.
  50. 50. HONEYCOMBING OF LUNGS Clustered thick walled cystic spaces representing dilated and thickened bronchial walls, seen in BRONCHIECTASIS AND CYSTIC FIBROSIS.
  51. 51. HILUM OVERLAY SIGN Differentiates large pulmonary artery from hilar mass on chest X ray, mass superimposes on vessels.
  52. 52. IVORY VERTEBRA Dense white vertebral body essentially of normal shape, most often from OSTEOBLASTIC PROSTATE, BREAST CA METS, PAGETS DISEASE.
  53. 53. JUXTAPHRENIC PEAK SIGN Tent like projection of the medial hemidiaphragm seen with UPPER and sometimes MIDDLE LOBE ATELECTASIS.
  54. 54. J SHAPED SELLA Sella extends under anterior clinoid process and looks like J on side, seen in NORMALS, HYDROCEPHALUS OR OPTIC CHIASM GLIOMA
  55. 55. LEAD PIPE COLON SIGN Rigid, ahaustral appearance of colon classically seen with CHRONIC ULCERATIVE COLITIS.
  56. 56. LICKED CANDY STICK SIGN Tapered appearance of metacarpals, phalanges and clavicles seen with PSORIATIC ARTHRITIS.
  57. 57. MERCEDES BENZ SIGN Triradiate radiolucent shadow seen in Rt upper quadrant of the abdomen s/o GALLSTONES.
  58. 58. NAPOLEAN HAT SIGN Inverted hat like appearance of L5 vertebra on frontal view in SEVERE ANTEROLISTHESIS OF L5 ON S1.
  59. 59. OIL DROPLET SIGN Multiple punched out lytic defects seen in MULTIPLE MYELOMA.
  60. 60. PEAR SHAPED BLADDER Shape of urinary bladder from extrinsic compression from excess pelvic fat, fluid, blood, urine or adenopathy.
  61. 61. PICTURE FRAMING VERTEBRA Thickened cortex of vertebral body with PAGET’S DISEASE resembling a picture frame.
  62. 62. PSEUDOTUMOR AKA VANISHING TUMOR, fluid in fissure mostly seen in CHF, which vanishes with reversal of failure.
  63. 63. PUTTY KIDNEY "Putty kidney" – sacs of casseous, necrotic material (TB) Autonephrectomy – small, shrunken kidney with dystrophic calcification
  64. 64. RUGGER JERSEY SPINE Sclerotic superior and inferior endplates of vertebrae from secondary hyperparathyroidism from renal disease.
  65. 65. RAT BITE SIGN Sharply marginated, overhanging bony erosions usually associated with GOUTY ARTHRITIS.
  66. 66. RICE GRAIN CALCIFICATION Elongated oval shaped, soft tissue calcifications of rice grain size seen in CYSTICERCOSIS
  67. 67. SNOWMAN HEART SIGN Dilated vertical vein and SVC form head of snowman in type 1 SUPRACARDIAC TAPVC.
  68. 68. SWAN NECK DEFORMITY Hyperextension of PIP jt and flexion of DIP jt seen in RHEUMATOID ARTHRITIS.
  69. 69. SILVER FORK DEFORMITY Appearance of acutely dorsally angulated wrist from distal radius # seen in COLLE’S #.
  70. 70. SNOWSTORM APPEARANCE Innumerable small pulmonary nodules frequently associated with metastatic CA from thyroid.
  71. 71. STRING SIGN Very thin luminal contrast usually in terminal ileum from spasm and eventually fibrosis seen in mostly in CROHN’S DISEASE.
  72. 72. STEP LADDER APPEARANCE Loops arrange themselves from left upper to right lower quadrant in distal SBO
  73. 73. SUNBURST SIGN Highly aggressive spiculated reaction indicating a malignancy such as OSTEOSARCOMA.
  74. 74. SALT AND PEPPER SKULL Multiple small areas of resorption of skull in HYPERPARATHYROIDI SM results in mottled appearance like salt and pepper.
  75. 75. THUMB PRINT SIGN Indentation in contrast or air filled bowel lumen caused by submucosal infiltration resembling thumbprint seen in ISCHAEMIC COLITIS.
  76. 76. THUMB SIGN Enlarged epiglottis in EPIGLOTTITIS is stubby like thumb instead of its usual thin fingerlike projection.
  77. 77. WATERBOTTLE HEART SIGN Globular shape of heart from a large PERICARDIAL EFFUSION.
  78. 78. THANK YOU!!