» Radiology Signs

Radiology Signs

 

A

Accordion sign

Appearance of bowel that may be seen with pseudomembranous colitis.

Air crescent sign

Appearance of cavitation that may be seen with invasive apergillosis (see also Monod sign).

Anteater’s nose sign

Sign of calcaneonavicular tarsal coalition.

Apple Core lesion

Circumferential narrowing of the lumen secondary to colon cancer.

 

 

[edit] B

Ball on tee sign

Sign of papillary necrosis on IVU.

Banana sign

Seen on antenatal US and refers to a banana-shaped configuration of the cerebellum. Associated with neural tube defects.

Bat wing appearance (chest)

Classic chest radiography finding for pulmonary edema.

Bat wing appearance (neuro)

Appearance of 4th ventricle that may be seen with Joubert syndrome.

Bergman’s coiled catheter sign

Sign of ureteral transitional cell carcinoma when a catheter coils in region of neoplasm (see also Goblet sign).

Bird’s beak

Narrowing of the esophagus in achalasia.

Bird’s beak sign or bird of prey sign

Narrowing of the colon in cecal volvulus.

Blade of grass

Paget disease.

Bone in bone sign

Appearance of spine that may be seen osteopetrosis.

Boot-shaped Heart

Appearance of heart that may be seen with tetralogy of Fallot.

Boxcar ventricles

Appearance of frontal horns that may be seen in Huntington’s disease.

Breast in a breast

Term used to describe Fibroadenolipomas.

Bulging fissure sign

Bulging of a pulmonary fissure. Most commonly associated with Klebsiella pneumonia.

Bullet carpal bones

Appearance of carpal bones that may be seen with mucopolysaccharidoses.

Butterfly vertebrae

Results from failure of fusion of the lateral halves of the vertebral body because of persistent notochondal tissue between them.

 

 

[edit] C

C sign

Sign of talocalcaneal tarsal coalition.

Cake kidney

All renal tissue is fused into one pelvic mass and gives rise to two separate ureters which enter the bladder in normal relationship.

Canoe paddle ribs

:Appearance of ribs that may be seen with mucopolysaccharidoses.

Celery stalking

Irregular appearance of metaphyses in patients with rubella. Also used to describe metaphyses in patients with osteopathia striata.

Central dot sign

Sign of Caroli’s disease.

Champagne sign

Specific but not commonly seen ultrasound finding for emphysematous cholecystitis.

Cloverleaf skull

Appreance of the skull that may be seen with thanatophoric dysplasia.

Cluster of grapes

Appearance that may be seen with pneumatosis cystoides coli.

Cobra head sign

Dilatation of the distal ureter which may be seen in patients with ureteroceles.

Coffee bean sign

Sigmoid volvulus.

Collar sign

Sign of diaphragmatic rupture.

Comet sign

Sign to differential a phlebolith from a ureteral stone. Calcified phlebolith represents the comet nucleus and the adjacent, tapering, noncalcified portion of the vein is the comet tail (also see soft-tissue rim sign).

Comet tail sign

Produced by the distortion of vessels and bronchi that lead to an adjacent area of round atelectasis.

Cord sign

Sign of intracranial dural sinus thrombosis.

Corkscrew collaterals

Appearance of collaterals that may be seen in patients with Buerger disease.

Corkscrew sign

Upper GI series sign of midgut volvulus.

Corduroy appearance

Appearance of thickening trabeculations seen in intraosseous hemangiomas of the spine. See also polka-dot pattern.

Crazy-paving sign

Nonspecific appearance consisting of linear network or reticular pattern with areas of ground-glass opacification. Classically associated with pulmonary alveolar proteinosis.

Crossover sign

Anterior acetabular rim is projected laterally relative to the same point of the posterior rim in the superolateral aspect of the acetabulum. See with pincer type femoroacetabular impingement.

Cyclops lesion

May occur status post anterior cruciate ligament reconstruction.

 

 

[edit] D

David Letterman sign

:Sign of scapholunate ligament disruption (also see Terry Thomas sign).

Dense vessel sign

Sign of cerebrovascular accident that represent thrombus in the middle cerebral artery.

Dependent viscera sign

Sign of diaphragmatic rupture (viscera falls to a dependent position).

Dot and dash pattern

Sacral insufficiency fracture.

Double bleb sign

Appearance of amnion and yolk sac at 5-6 weeks. Embryo lies between amnion and yolk sac

Double bubble sign

Sign of duodenal atresia and other forms of duodenal obstruction.

Double decidua sign

Sign of early normal intrauterine gestation.

Double density sign (cardiac)

Sign of left atrial enlargement when right side of the left atrium pushes into the adjacent lung.

Double density sign (Nucs)

Pattern of uptake that may be seen on bone scans in patients with osteoid osteomas.

Double duct sign

Simultaneous dilatation of the common bile and pancreatic ducts that is generally caused by a tumor in the pancreatic head.

Double PCL sign

MRI sign of a bucket-handle meniscal tear.

Double track sign

:Appearance of hypertrophic pyloric stenosis that may be seen on upper GI series.

Draped aorta sign

Sign of contained rupture of an abdominal aoric aneurysm.

Drooping lily sign

Inferolateral displacement of the opacified lower pole moiety in a duplex kidney from an obstructed (unopacified) upper pole moeity.

 

 

[edit] E

Egg on a string

Appearance of the heart that may be seen with transposition of great arteries.

Empty delta sign

Sign of intracranial dural sinus thrombosis.

Epicardial fat pad sign

Sign of a pericardial effusion.

Eye of the tiger sign

low signal intensity circumscribing the globus pallidus in patients with Hallervorden-Spatz syndrome.

 

 

[edit] F

Faceless kidney

Appearance of kidney secondary to any process that obliterates renal sinus (i.e. lymphomatransitional cell carcinoma).

Fallen fragment sign

Sign of a pathologic fracture seen with unicameral bone cysts.

Feeding vessel sign

Sign of pulmonary septic emboli.

Flame shaped (Breast)

Gynecomastia.

Flame shaped (MSK)

Paget disease.

Fat halo sign

Seen in various diseases of the bowel in which fatty infiltration of the submucosa is present.

Fat ring sign

Preservation of the perivascular fat around the mesenteric vessels that may be seen with mesenteric panniculitis.

Flat tire sign

Sign of a ruptured globe.

Flat waist sign

Appearance of left heart border that may be seen with left lower lobe atelectasis.

Figure 3 sign

Appearance of the aorta that may be seen in patients with coarctation of the aorta.

Figure of eight

Appearance of the brain in pachygyria.

Finger in glove sign

Sign of mucous plugging seen with allergic bronchopulmonary aspergillosis.

Fish vertebrae.

Description of shape of vertebral bodies that may be seen in patients with sickle cell disease. See also: H-shaped vertebral bodies.

Football sign

Sign of pneumoperitoneum seen on supine radiographs.

 

 

[edit] G

Gastrointestinal string sign

Sign of Crohn disease.

Goblet sign

Sign of ureteral transitional cell carcinoma that may be seen on retrograde or intravenous urography (see also Bergman’s coiled catheter sign).

Gull wing appearance

Appearance of erosions that may occur in patients with erosive osteoarthritis.

 

 

[edit] H

H-shaped vertebral bodies

Shape of vertebral bodies that may be seen in patients with sickle cell disease. See also: Fish vertebrae.

Halo sign

Ground-glass attenuation surrounding a pulmonary nodule or mass on CT images. Represents hemorrhage and is highly suggestive of Aspergillus.

Hampton’s hump

Triangular opacity secondary to infarction in the periphery of the lung distal to a pulmonary embolism.

Head cheese sign

Sign of subacute hypersensitivity pneumonitis.

Hidebound sign

On small bowel series, crowding of folds in dilated loops of small bowel may be seen in patients with scleroderma.

High-attenuating crescent sign

Sign of impending abdominal aoric aneurysm rupture.

Hole within a hole

Appearance that may be seen when eosinophilic granuloma involves the skull.

Holly leaf appearance

Chest radiograph finding that may be seen with asbestos pleural plaques.

Honda sign

Sacral insufficiency fracture.

Hot cross bun sign

May be seen on axial T2 weighted images of the pons in multiple system atrophy.

Hot nose sign

Sign that may be observed on brain flow scans in patients with brain death.

Hourglass appearance

MRI appearance that may be seen with concentric cystic adventitial disease.

 

 

[edit] I

Interstitial line sign

Sign that may be seen with an interstitial ectopic pregnancy.

Inverted Napoleon’s hat sign

Sign of severe spondylolisthesis at the lumbosacral junction.

Ivory vertebra sign

Increase in opacity of a vertebral body that retains its size and contours, with no change in the opacity and size of adjacent intervertebral disks.

 

 

[edit] J

Juxtaphrenic peak sign

Tenting of the diaphragm that may be seen with right upper lobe atelectasis.

 

 

[edit] K

Keyhole sign

US appearance that may be seen with posterior urethral valves.

 

 

[edit] L

Lace like

Pattern that may be seen with sarcoid arthropathy.

Lace-like pattern

Ultrasound appearance of hemorrhagic ovarian cysts.

Lacunar skull

Appearance of skull that may be seen in infants with Chiari II malformation.

Lambda sign

On a Gallium-67 citrate scan, uptake in the hilar and paratracheal lymph nodes gives the appearance of a lambda. This is seen in sarcoidosis.

Lead pipe

Narrowing of colon with loss of haustra that may be seen in patients with ulcerative colitis.

Linguine sign

MRI sign that may be seen in patients with intracapsular breast implant rupture.

Lobster claw sign

Sign of papillary necrosis on IVU.

Lollipop

Appearance of diverticula that may been seen on HSG in patients with adenomyosis.

Luftsichel sign

“Air cresent”. Sign that may be seen with left upper lobe atelectasis.

 

 

[edit] M

Mark Morton sign

Throckmorton’s sign with a small penis.

Mercedes Benz sign

Appearance of gas within gallstones.

Moulage sign

Effaced loop of bowel that may be seen on a small bowel series in sprue.

Molar tooth sign (GU)

Perivesicular extravasation of contrast on CT cystogram in a patient with extraperitoneal bladder rupture.

Molar tooth sign (Neuro)

Enlarged and horizontally directed tubular structure on each side of the midline emerging from the midbrain in patients with Joubert syndrome.

Monod sign

Air surrounding an aspergilloma (Also see air crescent sign).

Mount Fuji sign

CT sign of tension pneumocephalus.

 

 

[edit] N

Naclerio’s V sign

V shaped lucency that may be seen over the left lower mediastinium in pneumomediastinum.

Nipple sign

Appearance of hypertrophic pyloric stenosis that may be seen on ultrasound.

Nubbin sign

Reflux nephropathy involving the lower pole of a duplicated collecting system.

Nutmeg liver

Pattern of liver enhancement seen with passive congestion.

 

 

[edit] O

Onion ring appearance

US appearance that may be seen with a testicular epidermoid cyst.

 

 

[edit] P

Paintbrush appearance

Linear striations of contrast material opacifing collecting tubules that may be seen with medullary sponge kidney.

Panda sign

On a Gallium-67 citrate scan, uptake in the lacrimal and salivary glands gives the appearance of a panda. This is suggestive of sarcoidosis.

Parallel track sign

Pattern of uptake that may be seen on bone scan in patients with hypertrophic osteoarthropathy.

Pear-shaped bladder

Bladder assumes the shape of a pear when it undergoes extrinsic compression due to excess tissue in the pelvis.

Pearl necklace sign

MRI sign that may be seen with adenomyomatosis.

Pencil in cup deformity

Erosion pattern of digits that may be seen in patients with psoriatic arthritis.

Picture frame vertebral body

Thicken cortex of vertebral bodies that may be seen in patients with Paget disease.

Picket fence

Appearance of bowel that may be seen on small bowel series with Whipple disease or gastrointestinal amyloidosis.

Pistol grip deformity

Appearance of the proximal femur that may be seen with cam type femoroacetabular impingement.

Playboy bunny sign

US sign of the appearance of the confluence of the hepatic veins with the IVC.

Polka-dot pattern

Appearance of thickening trabeculations seen in intraosseous hemangiomas of the spine. See also Corduroy appearance.

Porcelain gallbladder

Calcification of the gallbladder wall.

Putty kidney

Appearance that may be seen with end-stage renal tuberculosis.

 

 

[edit] R

Reversal sign

CT sign of anoxic brain injury where gray matter is lower in attenuation that white matter (the opposite is normal).

Reversed halo sign

Relatively specific sign of pulmonary nodules in cryptogenic organizing pneumonia.

Ribbon bowel

Appearance of bowel that may be seen on barium studies in graft versus host disease.

Ribbon ribs

Appearance of ribs that may be seen with neurofibromatosis 1.

Rice kernel

CT appearance that may be seen with dacryolithiasis.

Rigler’s sign

Sign of pneumoperitoneum where both sides of a loop of bowel are outlined by air.

Rim sign

On cholescintigraphy, increased uptake is seen in the region of the gallbladder fossa. Sign is specific for acute cholecystitis.

Ring of fire sign

US finding. Hypervascular ring in the adnexa that may be seen with either ectopic pregnancy or corpus luteum.

Ring sign

CT sign of epiploic appendagitis.

Rosary sign

CT sign that may be seen with adenomyomatosis.

Rugger jersey spine sign

Appearance of spine that may be seen with hyperparathyroidism.

 

 

[edit] S

S sign of Golden

Right upper lobe atelectasis created by a central mass. Should raise the suspicion of a central neoplasm.

Saber-sheath trachea

Appearance of trachea that may be seen with COPD.

Saber shin

Appearance of tibia that may be seen with syphilis.

Sandstorm appearance

Appearance of lungs that may be seen in pulmonary alveolar microlithiasis.

Salt and pepper pattern

Flow voids seen in glomus tumors.

Salt and pepper skull

Appearance of skull that may be seen in patients with hyperparathyroidism.

Sandwich sign

Bulky lymphoma encasing mesenteric vessels.

Sandwich vertebra

Sclerotic endplates that may be seen with osteopetrosis.

Sausage digit

Soft tissue swelling of digits in patients with psoriatic arthritis.

Scimitar sign

MRI appearance that may be seen with eccentric cystic adventitial disease.

Scottie dog

On oblique radiographs, the posterior elements form the appearance of a Scottie dog. Spondylolysis can have the appearance of a collar around the neck.

Shepard’s crook deformity

Appearance of proximal femur that may be seen with fibrous dyplasia.

Shoulder sign

:Appearance of hypertrophic pyloric stenosis that may be seen on upper GI series.

Signet ring sign (Chest)

Sign of bronchiectasis.

Signet ring sign (GU)

Sign of papillary necrosis on IVU.

Small heart sign

Sign of tension pneumopericardium.

Snowman

Appearance of heart that may be seen with supracardiac total anomalous pulmonary venous return.

Snowstorm pattern (breast)

US pattern for breast implant rupture.

Snowstorm pattern (Ob/gyn)

US pattern for a molar pregnancy.

Soft-tissue rim sign

Appearance of a ureteral edema surrounding a calculus. Helps differentiates a calculus from a phlebolith (also see comet sign).

Spade shape

Shape of tufts that may be seen with acromegaly.

Spalding sign

Overlapping cranial sutures. Sign of fatal demise on prenatal ultrasound.

Spider web

Appearnace of collateral vessels that may be seen on hepatic venography in Budd-Chiari syndrome.

Spinnaker sail sign

Elevation of the thymus by air that may be seen with pneumomediastinum.

Spinning top urethra

Split pleura sign

CT sign of thoracic empyema.

Spoke wheel enhancement pattern (GU)

May be seen with oncocytomas

Spoke wheel enhancement pattern (GI)

May be seen with focal nodular hyperplasia.

Spokewheel sign (GI)

Pattern of mesentery that may be seen with small bowel volvulus.

Starry sky

US appearance that may be seen with hepatitis.

Steeple sign

Appearance of narrowing of the subglottic tracheal lumen that may be seen with croup.

Stepladder sign

US sign that may be seen in patients with intracapsular breast implant rupture.

Straight line sign

PET sign of peritoneal carcinomatosis.

Strawberry skull

Appearance of skull that may be seen on fetal US with Trisomy 18.

String of beads

Appearnace of multiple stenosis that may be seen in patients with fibromuscular dysplasia.

String sign

Appearance of hypertrophic pyloric stenosis that may be seen on upper GI series.

Stripe sign

On a V/Q scan, subpleural activity in a region of decreased pulmonary perfusion. Sign is used to rule out pulmonary embolism.

Superior triangle sign

Sign that may be seen with right lower lobe atelectasis.

 

 

[edit] T

Talar beak

:Sign of talocalcaneal tarsal coalition.

Tau sign

MRI sign of a persistent trigeminal artery.

Telephone receiver shaped femora

Appearance of femora that can be seen with thanatophoric dysplasia.

Terry Thomas sign

Sign of scapholunate ligament disruption (also see David Letterman sign).

Throckmorton’s sign

The penis points to the pathology.

Thumb sign

Classic lateral radiographic finding for epiglotitis.

Thumbprinting

Sign of bowel wall thickening seen with entities such as ischemic boweldiverticulitisCrohn’s disease, and ulcerative colitis.

Tip of the iceberg sign

Ultrasound sign that may be seen with mature cystic teratomas.

Tit sign

:Appearance of hypertrophic pyloric stenosis that may be seen on upper GI series.

Tram-track sign (chest)

Sign of bronchiectasis.

Tram-track sign (neuro)

Sign of optic nerve meningioma.

Tram-track sign (neuro)

Appearance of cortical calcifications that may be seen with Sturge-Weber syndrome.

Tram-track sign (nucs)

Bone scan finding that may be seen with hypertrophic osteoarthropathy.

Tree in bud

Nonspecific pulmonary pattern seen on thin-section computed tomography.

Trident hand

Appearance of hands that may be seen with achondroplasia.

Trough line sign

In posterior shoulder dislocation, frontal radiographs reveal two nearly parallel lines in the superomedial aspect of the humeral head.

 

 

[edit] U

Umbrella sign

Sign of a ruptured globe.

 

 

[edit] W

Wall-echo-shadow sign

Sign of cholelithiasis on US when the gallbladder is filled with calculi.

Waterlily sign

Sign of hydatid cyst.

Watering can perineum

Sign of fisula formation secondary to periurethral abscess.

Wave sign

Sign produced by lateral indentation of thymus by adjacent anterior ribs. This sign in seen in the pediatric population and represents a normal thymus.

Whirlpool Sign

US sign of midgut volvulus in a neonate.

Wimberger’s ring sign

A circular, opaque radiologic shadow surroundsing epiphyseal centers of ossification in patients with scurvy.

Wimberger’s sign

Symmetrical lesions seen in the proximal tibial medial metaphysis in patient’s with syphilis.

Westermark’s sign

Regional pulmonary oligemia secondary to pulmonary embolism.

 

 

[edit] Y

Yin-yang sign

Swirling blood flow pattern within a pseudoaneurysm.

Yo-yo on a string sign

MRI appearance of a Stener lesion (see Gamekeeper thumb)

 

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