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Common Radiological
signs
Presented by
Dr Laith fadhel
MBchB, P.G.C.R
Hilum Overlay Sign
differentiates large pulmonary artery from hilar mass
on chest x-ray; mass superimposes on vessels
Fat Pad Sign
elevation of extrasynovial, intracapsular fat around the
elbow as a result of distension of the joint by an
effusion, usually traumatic
David Letterman Sign
widening of distance between the scaphoid and lunate
(>3mm) on PA view from ligament disruption-AKA Terry
Thomas sign
Onion Skin Periosteal Reaction
lamellar reaction from concentric layers of new
growth seen in Ewing's, osteomyelitis, and
osteosarcoma
Codman's Triangle
triangular elevation of periosteum from an
aggressive, usually malignant, bone tumor such as
an osteosarcoma
Oil Droplets
multiple punched-out lytic defects seen in multiple
myeloma
Cotton Wool Appearance
islands of poorly marginated sclerotic disease
surrounded by less dense skull in Paget disease
Cobra Head Abnormality
rounded dilatation of distal ureter, surrounded by thin
lucent line, seen in patients with adult-type
ureteroceles
Mercedes Benz Sign
Tri-radiate appearance of air in gallstone seen on
CT and plain films
Omental Cake
plaque-like Neoplastic infiltration of the greater
omentum most often caused by stomach, colon or
ovarian carcinoma
Crescent Sign
appearance of a sliver of air usually best seen beneath
the right hemi diaphragm in pneumoperitoneum
Falciform Ligament Sign
visualization of usually invisible falciform ligament from
surrounding air in pneumoperitoneum
Corkscrew Esophagus
constricted, twisted lumen usually seen in diffuse
esophageal spasm from abnormal, tertiary contractions
Thumb printing
indentation in contrast or air-filled bowel lumen
caused by sub mucosal infiltration and resembling a
thumbprint; e.g. ischemia
Cobblestone Appearance
GI-alternating normal and denuded mucosa from
ulceration, esp. in Cohn's disease of the colon
Lead Pipe Colon
rigid, ahaustral appearance of colon classically
seen with chronic ulcerative colitis
Coffee-bean Sign
dilated sigmoid colon in sigmoid volvulus thought to
resemble a giant coffee-bean
Colon Cutoff Sign
dilated transverse colon, usually to splenic flexure,
associated with pancreatitis or ischemic colitis
Apple Core
appearance of an annular constricting carcinoma of the
bowel, usually the colon, from circumferential
involvement of lumen

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