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Article
Abnormal bowel wall attenuation patterns
Abnormal bowel wall attenuation patterns on CT scan can be grouped under five categories: white enhancement
gray enhancement water halo sign fat halo sign black attenuation The first three patterns are seen on contrast
studies. White enhancement It is defined as uniform enhancement of th...
Article
Abnormally eccentric gestational sac
An eccentrically-located gestational sac towards the fundus of the uterus is the normal sonographic appearance;
however an abnormally eccentric gestational sac on ultrasound may be apparent due to a number of causes They
include interstitial ectopic pregnancy 1 normally implanted pregnancy in...
Article
Absent bow tie sign (knee)
The absent bow tie sign represents the loss of the normal appearance of the menisci on parasagittal MRI images,
and is suggestive of meniscal injury. Normally the medial and lateral menisci appear as low signal bow-tie-
shaped structures between the femoral condyles and tibial plateaux. As the n...
Article
Absent nasal bone
In a fetal sonographic assessment, an absent nasal bone is a feature which can sometimes be used as an
adjunctive marker for fetal aneuploidy. Radiographic assessment Antenatal ultrasound It is assessed on a midline
sagittal view. In this section, the nasal bone is often seen as a bright echo...
Article
Accordion sign (colon)
The accordion sign (also known as concertina sign) is seen on CT examinations of the abdomen and refers to the
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similarity between the thickened oedematous wall of pseudomembranous colitis and the folds of an accordion.
This appearance is the result of hyperaemic enhancing mucosa stretched over m...
Article
Ace-of-spades sign (heart)
Ace-of-spades sign refers to the pathognomonic configuration of the left ventricle as seen in apical hypertrophy
1-3. It consists of marked ventricular wall thickening at the apex resulting in cavity narrowing at the apex with a
relatively normal appearance of the mid-ventricular to basal wall ...
Article
Adie pupil
Adie pupil (also known as tonic pupil) is caused by idiopathic degeneration of the ciliary ganglion, which
sometimes occurs following a viral or bacterial illness. It is usually unilateral and typically affects young
females 1. Adie pupil represents a large dilated "tonic pupil", which does not...
Article
Air bronchogram
Air bronchogram refers to the phenomenon of air-filled bronchi (dark) being made visible by the opacification of
surrounding alveoli (grey/white). It is almost always caused by a pathologic airspace/alveolar process, in which
something other than air fills the alveoli. Air bronchograms will not ...
Article
Air bubble sign (tension pneumocephalus)
The air bubble sign is seen on CT of the brain and represents multiple small foci of air within the subarachnoid
space, especially the Sylvian fissure.1 Although described as a sign of tension pneumocephalus it is also seen in
pneumocephalus without elevated pressures.2 It should not be con...
Article
Air crescent sign (lung)
An air crescent sign describes the crescent of air that can be seen in invasive aspergillosis, semi-invasive
aspergillosis or other processes that cause pulmonary necrosis. It usually heralds recovery and is the result of
increased granulocyte activity. In angioinvasive fungal infection, the no...
Article
Air trapping
Air trapping in chest imaging refers to retention of excess gas (“air”) in all or part of the lung, especially during
expiration, either as a result of complete or partial airway obstruction or as a result of local abnormalities in
pulmonary compliance. It may also sometimes be observed in norma...
Article
Andersson lesion
Andersson lesions refer to an inflammatory involvement of the intervertebral discs by spondyloarthritis.

Epidemiology Rheumatic spondylodiscitis is a non-infectious condition that has been shown to occur in about
8% of patients with ankylosing spondylitis, as detected at radiography. Patholog...

Article
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Angular interface sign
The angular interface sign is used to characterise an exophytic renal mass, in which the exophytic renal mass has
an angular interface with the renal parenchyma. In other words, the exophytic lesion has a tapered pyramidal
contour or definite apex within the renal parenchyma. Due to its high se...
Article
Animal and animal produce inspired signs
Animal and animal produce inspired signs may sound a little silly, but the radiology literature is replete with
such signs, some more fanciful than others. Fish and seafood endosteal scalloping: medullary cavity masses, e.g.
multiple myeloma fish vertebra (also known as codfish vertebra): bic...
Article
Anteater nose sign (foot)
The anteater nose sign refers to an anterior tubular elongation of the superior calcaneus which approaches or
overlaps the navicular on a lateral radiograph of the foot. This fancifully resembles the nose of an anteater and is
indicative of calcaneonavicular coalition 1,2. History and etymolog...
Article
Anterior bronchus sign
The anterior bronchus sign refers to the appearance of the anterior segmental bronchus of the upper lobes as seen
on a frontal chest radiograph. Normal anatomy The anterior segment bronchus of the upper lobes courses
anteriorly and laterally. When the orientation is predominantly anteriorly th...
Article
Anterior tibial translocation sign
The anterior tibial translocation sign or anterior drawer sign (a.k.a. anterior translation of tibia) is seen in cases
of complete rupture of the anterior cruciate ligament, and refers to anterior translocation (anterior tibial
subluxation) of the tibia relative to the femur of >7 mm 1.
Article
Antral nipple sign
The antral nipple sign refers to redundant pyloric mucosa protruding into the gastric antrum and is seen in
pyloric stenosis. See also cervix sign of pyloric stenosis target sign of pyloric stenosis shoulder sign of pyloric
stenosis
Article
Antral pad sign
The antral pad sign is a feature seen on a spot radiograph of the upper gastrointestinal tract obtained with orally-
administered contrast material. It refers to the extrinsic impression or indentation on the posteroinferior aspect of
the antrum. The impression is generally arcuate and smooth, an...
Article
Apple core sign (colon)

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The apple core sign, also known as a napkin ring sign (bowel), is most frequently associated with constriction of
the lumen of the colon by a stenosing annular colorectal carcinoma. Differential diagnosis The appearance of the
apple-core lesion of the colon also can be caused by other diseases...
Article
Apple core sign (femur)
The apple core sign has been used to describe the circumferential erosion of the femoral neck seen in synovial
chondromatosis. Although this is the most common process that may lead to an apple core erosion of the femoral
neck, this has also been observed with: pigmented villonodular synovitis ...
Article
Apple-peel intestinal atresia
Apple-peel intestinal atresia, also known as type IIIb or Christmas tree intestinal atresia, is a rare form of small
bowel atresia in which the duodenum or proximal jejunum ends in a blind pouch and the distal small bowel
wraps around its vascular supply in a spiral resembling an apple peel. Oft...
Article
Arcuate sign (knee)
The arcuate sign is often a subtle but important finding on knee x-rays and represents an avulsion fracture of the
proximal fibula at the site of insertion of the arcuate ligament complex, and is usually associated with cruciate
ligament injury (~90% of cases) 2. The fracture fragment is attache...
Article
Argyll Robertson pupil
Argyll Robertson pupil is usually bilateral and presents as bilaterally miotic and irregular pupils, which constrict
briskly with accommodation but do not react to bright light therefore displaying light-near dissociation 1. It is a
highly specific sign of late neurosyphilis, however can also ...
Article
Arrowhead sign (caecum)
The arrowhead sign refers to the focal caecal thickening centred on the appendiceal orifice, seen as a secondary
sign in acute appendicitis. The contrast material in the caecal lumen assumes an arrowhead configuration,
pointing at the appendix. The arrowhead sign is applicable only when enter...
Article
Atoll sign (liver MRI)
The atoll sign in hepatic imaging has been described when a liver lesion shows a peripheral rim of high T2
signal intensity with the centre of the lesion appearing isointense to the background of non-cirrhotic liver on
T2WI mimicking an atoll. It is considered a characteristic sign of an inflamm...
Article
Atrial escape
Atrial escape refers to a chest x-ray sign of massive left atrial enlargement and is an exaggerated version of the
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double density sign. Normally, the right border of the left atrium is not visible. As it enlarges it forms a distinct
border projecting through the right heart shadow, medial to ...
Article
Aubergine sign (penis)
The aubergine sign (also known as egg-plant sign or deformity) is a clinical sign of a fractured penis.
Haemorrhage beyond the tunica albuginea produces swelling and bruising of the penis simulating the
appearance of an aubergine.
Article
Baastrup syndrome
Baastrup syndrome (also referred to as kissing spines) results from adjacent spinous processes in the lumbar
spine rubbing against each other and resulting in hypertrophy and sclerosis with focal midline pain and
tenderness relieved by flexion and aggravated by extension. Epidemiology It tend...
Article
Backwash ileitis
Backwash ileitis is seen in patients with ulcerative colitis (UC), where the entire colon is involved. In such cases
the terminal ileum is oedematous. Backwash ileitis extends contiguously backward from the caecum without
skip regions. One source estimates it to occur in 6% of patients with UC,...
Article
Ballet sign
The ballet sign refers to the paralysis of voluntary movements of the eyeball with preservation of the automatic
movements. Sometimes this sign is present with exophthalmic goitre and hysteria.
Article
Ball of wool sign (hydatid cyst)
The ball of wool sign, also referred to as the yarn sign or congealed water lily sign, is an ultrasound appearance,
representing degeneration of hydatid cysts (WHO class CE 4). The inner side of the cyst detaches from the cyst
wall and folds on itself, causing a change from anechoic (fluid) to a...
Article
Balloon on a string sign (ureter)
The balloon on a string sign refers to the appearance of the ureter on intravenous urography in ureteropelvic
junction obstruction. It is seen due to the high and eccentric point of the exit of ureter from a dilated renal
pelvis.
Article
Bamboo spine
Bamboo spine is a radiographic feature seen in ankylosing spondylitis that occurs as a result of vertebral body
fusion by marginal syndesmophytes. It is often accompanied by fusion of the posterior vertebral elements as
well. A bamboo spine typically involves the thoracolumbar and/or lumbosacr...
Article
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Banana sign (cerebellum)
The banana sign is one of the many notable fruit inspired signs. It is seen on axial imaging through the posterior
fossa of the fetus and is associated with the Chiari II malformation. It describes the way the cerebellum is
wrapped tightly around the brain stem as a result of spinal cord tether...
Article
Bare orbit sign (sphenoid wing)
The bare orbit sign, is described as a characteristic appearance of the orbit, seen when the innominate line is
absent. The innominate line is a projection of the greater wing of the sphenoid, and its absence or destruction is
responsible for this appearance. It is the classical frontal radiogr...
Article
Battle sign (base of skull fracture)
Battle sign in an eponymous term given to mastoid ecchymosis (bruising of the scalp overlying the mastoid
process) and is suggestive of a base of skull fracture, most commonly a petrous temporal bone fracture. History
and etymology Mr William Henry Battle (1855-1936) was an English surgeon, w...
Article
Bat wing 4th ventricle
Bat wing 4th ventricle sign refers to the morphology of the fourth ventricle in the Joubert anomaly and related
syndromes. The absence of a vermis with apposed cerebellar hemispheres give the fourth ventricle an
appearance reminiscent of a bat with its wings outstretched. It is best demonstrate...
Article
Bat wing opacities (lungs)
Bat's wing or butterfly pulmonary opacities refer to a pattern of bilateral perihilar shadowing. It is classically
described on a frontal chest radiograph but can also refer to appearances on chest CT 3-4. Differential diagnosis
Bat's wing pulmonary opacities can be caused by: pulmonary oedem...
Article
Bayonet deformity
Bayonet deformity is a term used to describe the shape of the wrist in certain conditions: Madelung deformity
hereditary multiple exostosis with pseudo-Madelung deformity retarded bone growth of the distal ulna with
outward bowing of the radius with distal radioulnar joint subluxation Colles...
Article
Beak sign (arterial dissection)
The beak sign of arterial dissection is the acute angle formed at the edge of the false lumen in aortic dissection in
axial cross-section. It is formed by the borders of the outer aortic wall and the intimal flap, and may be partially
thrombosed (blunted beak). It is a reliable characteristic wh...
Article
Beak sign (pyloric stenosis)

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Beak sign in pyloric stenosis is one of the fluoroscopic (barium meal) findings which is useful in the diagnosis
of congenital hypertrophic pyloric stenosis. Radiographic features Barium meal A beak-like tapering projection
of barium is seen entering into the narrowed and compressed pyloric ...
Article
Bear paw sign (kidney)
The bear paw sign is seen in xanthogranulomatous pyelonephritis and refers to the cross-sectional appearance of
the kidney which is said to resemble the paw of a bear. The renal pelvis is contracted whereas the calyces are
dilated, mimicking the toe-pads of the paw.
Article
Beck triad
Beck triad is a collection of three clinical signs associated with pericardial tamponade which is due to an
excessive accumulation of fluid within the pericardial sac. The three signs are: low blood pressure (weak pulse
or narrow pulse pressure) muffled heart sounds raised jugular venous pre...
Article
Big rib sign
The big rib sign is a sign to differentiate right and left ribs on lateral chest radiographs. It exploits a technique of
magnification differences on lateral projections between right and left ribs. For example, on right lateral
projections the left ribs appear larger than right ribs. This s...
Article
Bilateral adrenal gland hyperenhancement
Bilateral adrenal gland hyperenhancement or intense adrenal enhancement may be a feature of hypotension and
forms part of the CT hypoperfusion complex. Adrenal gland hyperenhancement has been described in paediatric
and small adult series or individual cases of haemorrhagic shock, pancreatitis,...
Article
Bird beak sign (disambiguation)
Bird beak sign is used in many contexts to denote a rapid tapering to a point, reminiscent of a bird's beak.
Described bird beak signs include: beak sign (arterial dissection) beak sign (pyloric stenosis) bird beak sign
(oesophagus) bird beak sign (right colon) bird beak sign (sigmoid colo...
Article
Bird beak sign (oesophagus)
The bird's beak sign of the oesophagus is used to refer to the tapering of the inferior oesophagus in achalasia.
The same appearance (although it is difficult to see the similarity) is also referred to as the rat-tail sign. The
appearance, although classically occurring in primary achalasia, ca...
Article
Bird beak sign (right colon)
The bird beak sign of the right colon is tapering obstruction of the inferior part of right colon seen on contrast
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enema or CT scan with rectal contrast indicating caecal volvulus. This sign can help to differentiate caecal
volvulus from caecal bascule, in particular on a contrast/barium enema ...
Article
Bird beak sign (sigmoid colon)
Bird's beak sign of the sigmoid is one of the signs of sigmoid volvulus. It represents gradual narrowing/tapering
of sigmoid colon up to the level of obstruction during contrast/barium insertion to the rectum or on CT. When
located in the sigmoid colon, it suggests the diagnosis of sigmoid volv...
Article
Black turbinate sign (nasal cavity)
The black turbinate sign refers to an area of non-enhancing mucosa on MRI in a patient with angioinvasive
fungal sinus infection / rhinocerebral mucormycosis. Mucormycosis is caused by fungi that include
Mucor, Rhizopus, and Absidia species. It is seen in diabetic and immunocompromised patient...
Article
Blade of grass sign (Paget disease)
The blade of grass sign, also called the candle flame sign, refers to the lucent leading edge in a long bone seen
during the lytic phase of Paget disease of bone. The blade of grass sign is characteristic of Paget disease of
bone. This is akin to osteoporosis circumscripta cranii seen in the s...
Article
Blend sign (brain)
The blend sign refers to a CT appearance of early intracranial haematoma growth. It is defined as blending of a
hypoattenuating area and a hyperattenuating region with a well-defined margin.
Article
Bone within a bone appearance
Bone within a bone is a descriptive term applied to bones that appear to have another bone within them. There
are numerous causes including: normal thoracic and lumbar vertebrae (neonates and infants) growth recovery
lines (after infancy) cortical splitting and new periostitis sickle cell d...
Article
Boomerang sign (knee)
The boomerang sign is defined as a small displaced flap from a longitudinal horizontal type medial meniscal tear
which is displaced inferiorly into the medial meniscotibial recess. The imaging diagnosis of this type of tear is
crucial because it is normally hidden from the surgeon during routine...
Article
Boomerang sign (splenium)
The boomerang sign refers to a boomerang-shaped region of cytotoxic oedema in the splenium of the corpus
callosum typically seen in cytotoxic lesions of the corpus callosum (CLOCCs) 1-4. See also boomerang sign in
peroneus brevis split syndrome boomerang sign in horizontal meniscal flap tear
Article
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Bouchard node
Bouchard nodes are a clinical sign relating to bony nodules of the the proximal interphalangeal joints, and are
much less common than Heberden nodes. They generally (but not always) correspond to palpable osteophytes.
Clinical presentation They are sometimes painful, and are typically associat...
Article
Bouquet of flowers appearance (medullary sponge kidney)
A bouquet of flowers appearance is a description given to the appearances of medullary sponge kidney on a
traditional intravenous pyelogram (IVP) study. The ectatic distal collecting ducts contain the microcalcifications
typical of the disease. This is also known as the bunch of grapes appearanc...
Article
Boutonniere deformity
Boutonniere deformity is one of the musculoskeletal manifestations of rheumatoid arthritis in the hand with:
flexion contracture of the proximal interphalangeal (PIP) joints extension of the distal interphalangeal (DIP)
joints The defect appears in the tendon which splays open. The appearanc...
Article
Box-shaped heart
A box-shaped heart is a radiographic description given to the cardiac silhouette in some cases of Ebstein
anomaly. The classic appearance of this finding is caused by the combination of the following features: huge
right atrium that may fill the entire right hemithorax shelved appearance of th...
Article
Bracket sign (pars marginalis)
The bracket sign of the pars marginalis, also known as the pars bracket sign, refers to the appearances of the
superior most extent of the pars marginalis of the cingulate sulcus on axial imaging. It forms two roughly
symmetric brackets, open anteriorly. The next sulcus anteriorly is the central...
Article
Bracket sign (pericallosal lipoma)
The bracket sign refers to a radiographic appearance seen with the tubulonodular variety of pericallosal lipoma.
It reflects calcification seen at the periphery of the midline lipoma. It is best seen on coronal imaging and
historically was identified on frontal radiographs. It should not be con...
Article
Breast within a breast sign
The breast within a breast sign refers to the common mammographic appearance of breast hamartomas
(fibroadenolipomas). Since these benign lesions are well-circumscribed and contain a mixture of fibrous,
glandular and fatty tissue (just like normal breast), it is not surprising that they appear v...
Article
Bridging vessel sign

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The bridging vessel sign refers to an appearance of vessels coursing from the uterus into an adjoining pelvic
mass (a vascular bridge). This sign helps to differentiate a pedunculated subserosal uterine leiomyoma from
other juxtauterine masses of ovarian, adnexal or bowel origin. Colour and pow...
Article
Bright dot sign (atypical liver haemangioma)
The bright dot sign refers to the presence of a bright dot within a lesion which remains hyperattenuating on
arterial and portal venous phase CT, corresponding to early nodular enhancement seen on dynamic MRI of liver
haemangioma. This can be used as an indicator that the lesion in question is...
Article
Bright rim sign (anterior talofibular ligament injury)
The bright rim sign in anterior talofibular ligament injury refers to a sign seen on MRI. A cortical defect with a
bright dot-like or curvilinear high-signal-intensity, usually at the fibular attachment site, is seen on MRI. It has
been described as an indicator of ATFL injury 1. See also brig...
Article
Bright rim sign in dysembryoplastic neuroepithelial tumours
The bright rim sign has been described in dysembryoplastic neuroepithelial tumours (DNET) and is seen, as the
name so aptly describes, as a rim of high signal around the DNET on FLAIR sequences. The pathologic
correlate of this sign is glioneural elements loosely packed at the margin of the tum...
Article
Broken heart sign
The broken heart sign describes the appearances of incudomalleolar disarticulation. This sign is identified on CT
in the coronal plane, being formed by the widening of the incudomalleolar joint and lateral displacement of the
short process of the incus relative to the head of the malleus 1,2.
Article
Bronchial cut-off sign
The bronchial cut-off sign refers to the abrupt truncation of a bronchus from obstruction, which may be due to
cancer, mucus plugging, trauma or foreign bodies. Typically, there is associated distal lobar collapse.
Article
Bronchorrhoea
Bronchorrhoea is the expectoration of copious amounts of mucus from the lungs. It has been defined as
production of more than 100 mL of mucus in 24 hours, which is more than is usually seen in chronic lung
disease (e.g. chronic bronchitis typically produces 25 mL/24 hrs) 2. It may be a feature o...
Article
Brudzinski sign (meningism)
Brudzinski sign occurs in meningitis (of any aetiology) where passive flexion of one leg causes flexion in the
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opposite leg. Passive flexion of the neck brings about flexion of the legs as well. Historical context First
described by Jósef Brudziñski (1874-1917), paediatrician from Warsaw, Pola...
Article
Bubbly consolidation
Bubbly consolidation describes internal or central lucencies which represent normal aerated lung lobule within
infarcted, consolidated, lung parenchyma. It is one of the highly specific imaging appearances of focal
pulmonary haemorrhage or possibly pulmonary infarct secondary to pulmonary emboli...
Article
Bulging fissure sign
The bulging fissure sign refers to lobar consolidation where the affected portion of the lung is expanded causing
displacement of the adjacent fissure. Any type of pneumonia or space-occupying process can lead to bulging
(sagging) fissure sign. Classically, it has been described in upper right l...
Article
Bullet and bodkin sign
Bullet and bodkin sign is the appearance of the ureter when there is an abrupt transition in the ureteral caliber.
Bullet in the name is represented by the dilated proximal ureteric segment which appears to be perched on the
constricted / non-dilated encased ureter which gives an appearance of a...
Article
Bullet-shaped vertebra
Bullet-shaped vertebra refers to the anterior beaking of the vertebral body. It is seen in the following conditions:
mucopolysaccharidosis (Morquio disease, Hurler disease) achondroplasia congenital hypothyroidism See also
weapons and munitions inspired signs
Article
Bunch of grapes sign (disambiguation)
Bunch of grapes sign refers to the ultrasound appearance of multiple cystic spaces or lesions and it has been
described in a number of settings: within the uterus as a result of hydropic swelling of trophoblastic villi within a
hydatidiform mole in bronchiectasis, where on a chest radiograph, ...
Article
Butterfly glioma
Butterfly gliomas are a high grade astrocytoma, usually a glioblastoma (WHO grade IV), which crosses the
midline via the corpus callosum. Other white matter commissures are also occasionally involved. The term
butterfly refers to the symmetric wing-like extensions across the midline. Most freq...
Article
Butterfly sign (choroid plexus)
The butterfly sign refers to the normal appearance of the choroid plexuses on axial imaging of the fetal brain,
commonly observed on the antenatal ultrasound. Its absence may suggest holoprosencephaly 1. In the CNS, the
term should not be confused with a butterfly glioma, which is a glioblastom...

Article
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Butterfly vertebra
Butterfly vertebra is a type of vertebral anomaly that results from the failure of fusion of the lateral halves of the
vertebral body because of persistent notochordal tissue between them. Pathology Associations an anterior spina
bifida, with or without an anterior meningocele can be part of...
Article
Button sequestrum
A button sequestrum is a small sequestrum of devascularised bone surrounded by lucency. Although classically
described in osteomyelitis and eosinophilic granuloma it is also occasionally seen in fibrosarcoma and
lymphoma. Differential diagnoses osteoid osteoma tuberculous osteitis radiatio...
Article
Caecal bar sign
The caecal bar sign is a secondary sign in acute appendicitis. It refers to the appearance of inflammatory soft
tissue at the base of the appendix, separating the appendix from the contrast-filled caecum. See also arrowhead
sign
Article
Callosal angle
The callosal angle has been proposed as a useful marker of patients with idiopathic normal pressure
hydrocephalus (iNPH), helpful in distinguishing these patients from those with ex-vacuo ventriculomegaly (see
hydrocephalus versus atrophy). Method Ideally the angle should be measured on a cor...
Article
Calyceal crescent sign
The calyceal crescent sign (Dunbar crescents) refers to the early intravenous pyelogram (IVP) appearance of
markedly dilated renal calyces. It is formed by early contrast opacification of the dilated collecting ducts and
ducts of Bellini with the characteristic shape as a result of the associate...
Article
Cannonball metastases (lungs)
Cannonball metastases refer to large, well circumscribed, round pulmonary metastases that appear, well, like
cannonballs. The French term "envolée de ballons" which translates to "balloons release" is also used to describe
this same appearance. Metastases with such an appearance are classically...
Article
Capps triad
The Capps triad refers to the constellation of clinical and imaging findings in patients with spontaneous
retropharyngeal haematomas, and consists of: tracheal and oesophageal compression anterior displacement of
the trachea subcutaneous bruising over the neck and anterior chest History and ...
Article
Caput medusae sign (developmental venous anomaly)

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The caput medusae sign, refers to developmental venous anomalies of the brain, where a number of veins drain
centrally towards a single drain vein. The appearance is reminiscent of Medusa, a gorgon of Greek mythology,
who was encountered and defeated by Perseus. The sign is seen on both CT and ...
Article
Caput medusae sign (portal hypertension)
The caput medusae sign is seen in patients with severe portal hypertension. It describes the appearance of
distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to
join the systemic veins. History and etymology The appearance is reminiscent...
Article
Cardiac chamber enlargement
Cardiac chamber enlargement can be recognised by cardiac contour changes, new or different interfaces with
adjacent lung, and/or displacement of adjacent mediastinal structures. These are discussed separately: right atrial
enlargement right ventricular enlargement left atrial enlargement lef...
Article
Carman meniscus sign
The Carman meniscus sign describes the lenticular shape of barium in cases of large and flat gastric ulcers, in
which the inner margin is convex toward the lumen. It usually indicates a malignant ulcerated neoplasm; in cases
of benign gastric ulcers, the inner margin is usually concave toward th...
Article
Cartilage interface sign
Cartilage interface sign, also referred to as double cortex sign, refers to the sonographic presence of a thin
markedly hyperechoic line at the interface between the normally hypoechoic hyaline articular cartilage of the
humeral head and an abnormally hypoechoic supraspinatus tendon. This arises...
Article
Caterpillar sign
The caterpillar sign is a radiological sign described in pyloric stenosis. It refers to the appearance of stomach on
an upper gastrointestinal radiographic series or plain abdominal radiograph 1,2. On these imaging modalities in a
patient with pyloric stenosis, the stomach appears distended, ai...
Article
Caton-Deschamps index (knee)
The Caton-Deschamps index is a ratio that is used in everyday practice as well as in research to measure patellar
height and allows the diagnosis of patella alta and patella baja. Radiographic features The Caton-Deschamps
index is the ratio between the distance between the lower pole of the pa...
Article
Celery stalk metaphysis
Celery stalk metaphysis refers to a plain film appearance of the metaphyses in a number of conditions
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characterised by longitudinally aligned linear bands of sclerosis. They are seen in: congenital infections
congenital rubella congenital syphilis congenital cytomegalovirus (CMV) osteopathi...
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775 results found
Article
Kirklin complex
The Kirklin complex is a combination of the Carman meniscus sign associated with a radiolucent semicircular
zone surrounding the elevated ridge of the ulcer. This complex is seen in cases of gastric adenocarcinoma on
barium studies. History and etymology Byrl Raymond Kirklin, (1888-1957 2) an ...
Article
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Kirklin sign
The Kirklin sign refers to a deformity of the normal gastric bubble on an upright chest radiograph due to a mass
lesion of the gastric cardia or fundus. The differential for a Kirklin sign includes: gastric tumour gastric
carcinoma oesophageal carcinoma gastrointestinal stromal tumour (GIST...
Article
Kirner deformity
Kirner deformity is characterised by a curvature of the distal phalynx of the 5th digit in both a palmar and radial
direction. Epidemiology The deformity typically presents in late childhood to early adolescence, although a mild
deformity may be present at birth. Both sexes are affected, altho...
Article
Kissing carotids
The term kissing carotids refers to tortuous and elongated vessels which touch in the midline. They can be be
found in: retropharynx 2 intrasphenoid 1 within the pituitary fossa within sphenoid sinuses within sphenoid
bones The significance of kissing carotids is two-fold: may mimic intr...
Article
Knuckle sign (pulmonary embolism)
Knuckle sign refers to the abrupt tapering or cutoff of a pulmonary artery secondary to embolus. It is better
visualised on CT pulmonary angiography scan than chest x-ray. This is an important ancillary finding in
pulmonary embolism (PE), and often associated with the Fleischner sign of dilated ...
Article
Lambda sign
There are a number of lambda signs: lambda sign of twin pregnancy lambda sign of sarcoidosis
Article
Lambda sign (sarcoidosis)
The lambda sign is seen on gallium-67 scans in the setting of thoracic sarcoidosis. Bilateral hilar and right
paratracheal lymph nodes are typically involved which can resemble the Greek letter lambda (λ). See also
lambda sign of twin pregnancy
Article
Lateral crescent sign (inguinal hernia)
The lateral crescent sign is a useful diagnostic sign of a direct inguinal hernia on CT scan, the hernia causing
compression and lateral displacement of the inguinal canal contents (ductus deferens, testicular vessels, fat, etc.)
to form a semicircle of tissue that resembles a moon crescent seen...
Article
Lateral femoral notch sign (knee)

The (deep) lateral femoral notch sign describes a depression on the lateral femoral condyle at the terminal
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sulcus, a junction between the weight-bearing tibial articular surface and the patellar articular surface of the
femoral condyle. Pathology The likely mechanism is a hyperextension or im...
Article
Lead pipe sign (colon)
The lead pipe appearance of colon is the classical barium enema finding in chronic ulcerative colitis. There is
complete loss of haustral markings in the diseased section of colon, and the organ appears smooth-walled and
cylindrical.
Article
Lemon sign
The lemon sign, noted on antenatal imaging, is one of the many notable fruit-inspired signs. It is a feature when
there appears to be an indentation of the frontal bone (depicting that of a lemon). It is classically seen as a sign
of a Chiari II malformation and also seen in the majority (90-98%...
Article
Lentiform fork sign (basal ganglia)
The lentiform fork sign has been described on MRI and is seen as bilateral symmetrical hyperintensities in the
basal ganglia surrounded by a hyperintense rim delineating the lentiform nucleus. It has been postulated to result
from metabolic acidosis due to any cause 1, e.g. end stage renal dise...
Article
Leopard skin sign (white matter)
The leopard skin sign (also known as tigroid pattern or stripe sign) results from dark-spots or stripes (spared
perivascular white matter) within bright demyelinated periventricular white matter on T2W images. It is
characteristically seen in : metachromatic leukodystrophy Pelizaeus-Merzbacher...
Article
Lhermitte sign (spinal cord)
Lhermitte sign or the barber chair phenomenon is an electrical shock sensation running down the spine and into
the limb on neck flexion. It suggests compression of the upper cervical spinal cord and/or brainstem. Pathology
It is typically seen with multiple sclerosis but is also associated wit...
Article
Licked candy stick appearance (bones)
The term licked candy stick appearance refers to tapering of the tips of the metacarpal bones, metatarsal bones,
phalanges or clavicles and is usually associated with: psoriatic arthropathy rheumatoid arthritis leprosy
neuropathic joint
Article
Light bulb sign (hepatic haemangioma)
The light bulb sign of a hepatic haemangioma is a feature than can be seen on MRI imaging with a classic
hepatic haemangioma. This refers to marked hyperintensity seen on heavily T2 weighted sequences that has
been likened to a glowing light bulb. See also light bulb sign - shoulder light bul...
Article
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Light bulb sign (phaeochromocytoma)
The light bulb sign of an adrenal phaeochromocytoma is MRI feature of this tumour. This refers to marked
hyperintensity seen on T2 weighted sequences however this finding is neither sensitive nor specific and
phaeochromocytomas are more often heterogeneous with intermediate or high T2 signal int...
Article
Lightbulb sign (shoulder dislocation)
The lightbulb sign refers to the abnormal AP radiograph appearance of the humeral head in posterior shoulder
dislocation. When the humerus dislocates it also internally rotates such that the head contour projects like a
lightbulb when viewed from the front 1. See also light bulb sign (hepatic...
Article
Lincoln sign on bone scintigraphy
Lincoln sign on bone scintigraphy (also known as black beard sign) is one of the signs of Paget disease on the
radionuclide bone scan when the disease involves the mandible. The sign might be seen when the extensive
mandibular involvement with Paget disease results in the uptake of the radiotrac...
Article
Linguine sign (breast)
Linguine sign is one of the imaging signs of intracapsular rupture of a breast implant. After implantation of a
silicone or saline breast implant, a fibrous capsule (scar) forms around the implant shell. In an intracapsular
rupture, the contents of the implant are contained by the fibrous scar,...
Article
Lipohaemarthrosis
Lipohaemarthrosis results from an intra-articular fracture with escape of fat and blood from the bone marrow
into the joint, and is most frequently seen in the knee, associated with a tibial plateau fracture or distal femoral
fracture; rarely a patellar fracture. They have also been described in...
Article
Liver overlap sign
The liver overlap sign can be seen in sigmoid volvulus wherein the sigmoid loop is seen, usually on an
abdominal radiograph, ascending to the right upper quadrant and projecting over the liver shadow. In one study
of 21 patients with confirmed sigmoid volvulus, the sign was present in 9 patient...
Article
Locked facet joint
Locked facet joint is a type of facet joint dislocation that results from jumping of the inferior articular process
over the superior articular process of the vertebra below and becomes locked in the position. It can be unilateral
or bilateral. Radiographic features Plain radiograph The tip ...
Article
Loss of normal half-moon overlap sign

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Loss of half-moon overlap sign, which does not really roll off the tongue, is a sign of posterior shoulder
dislocation on AP radiographs. On a normal true anteroposterior image, there is a half-moon overlap between
the humeral head and the glenoid. In a posteriorly dislocated shoulder, there i...
Article
Loss of the insular ribbon sign
The loss of the insular ribbon sign refers to a loss of definition of the gray-white interface in the lateral margin of
the insular cortex ("insular ribbon") and is considered an early CT sign of MCA infarction. The insular cortex is
more susceptible to ischaemia following MCA occlusion than ot...
Article
Low attenuation lymphadenopathy
Low attenuation lymphadenopathy suggests underlying necrosis and can be seen in: metastatic carcinoma (or
lymphoma) infections (tuberculous or fungal) Whipple disease coeliac sprue inflammatory necrotic disorders
(e.g. Kikuchi-Fujimoto disease) See also lymphadenopathy low attenuation ly...
Article
Lower T sign
The lower T sign is one of the features useful in identifying the central sulcus on cross-sectional imaging. It
relies on identifying the inferior frontal sulcus which intersects the precentral sulcus in a "T" junction, thus
defining the precentral gyrus. The central sulcus is the next posteri...
Article
L sign (brain)
The L sign is one of the features useful in identifying the central sulcus on cross-sectional imaging. It relies on
identifying the superior frontal sulcus which intersects the precentral sulcus in an "L" junction, thus defining the
precentral gyrus. The central sulcus is the next posterior sul...
Article
Lucent liver sign
The lucent liver sign is represented by a reduction of hepatic radiodensity on supine radiograph when there is a
collection of free intraperitoneal gas located anterior to the liver.
Article
Luftsichel sign (lungs)
The luftsichel sign is seen in some cases of left upper lobe collapse and refers to the frontal chest radiographic
appearance due to hyperinflation of the superior segment of the left lower lobe interposing itself between the
mediastinum and the collapsed left upper lobe. Radiographic feature...
Article
Lung point sign
The lung point sign is a highly specific ultrasound sign of pneumothorax. It involves visualising the point where
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the visceral pleura (lung) begins to separate from the parietal pleural (chest wall) at the margin of a
pneumothorax. In the absence of pneumothorax, the two pleural layers slide a...
Article
Lyre sign (carotid artery)
The lyre sign refers to the splaying of the internal and external carotid by a carotid body tumour. Classically
described on angiography it is also visible on CT angiography.
Article
Macaroni sign (arteries)
Macaroni sign is a sign seen in Takayasu arteritis on ultrasound. It represents smooth, homogeneous and
moderately echogenic circumferential thickening of the arterial wall that occurs in Takayasu arteritis. The sign is
highly specific for Takayasu arteritis, more commonly noted in the common ca...
Article
Maiden waist deformity
Maiden waist deformity is the appearance of the deviation of bilateral ureters. This typically occurs in
retroperitoneal fibrosis. In this condition, there is medial indrawing of the ureters due to deposition of fibrous
tissue in the lumbosacral junction. Due to involvement of both ureters, the ...
Article
Mamillopontine distance
Mamillopontine distance is defined as the distance between the inferior aspect of the mammillary bodies to the
superior aspect of the pons. In normal subjects, it should be greater than 5.5 mm 1. It is decreased in conditions
that either depress the floor of the third ventricle or change the po...
Article
Manta ray sign (bladder)
The manta ray sign is a radiographic appearance in bladder exstrophy. It describes wide midline separation of
the pubic bones simulating the appearance of a manta ray swimming towards you 1. Differential diagnosis On a
plain radiograph consider: open book pelvic injuries: the smooth arc of th...
Article
Marcus Gunn pupil
Marcus Gunn pupil, also known as a relative afferent pupillary defect (RAPD), is a non-specific sign on physical
examination that indicates partial optic nerve dysfunction. It is mainly due to unilateral optic neuropathy (e.g.
optic neuritis), or rarely optic chiasm or optic tract lesions. This...
Article
Martini glass sign
The Martini glass sign describes the appearance of the globe in persistent hyperplastic primary vitreous (PHPV).
On MRI the retrolenticular tissue characteristic of this condition has a triangular shape, like that of a martini
glass appearing as low T2 low signal against the normal high T2 sign...
Article
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Matterhorn sign
The Matterhorn sign is a descriptive sign for a calcified disc herniation that impales the dural sac and sometimes
the cord, typically located in the thoracic spine. History and etymology The Matterhorn sign is named after one
of the most iconic mountains in the Alps: the Matterhorn.
Article
MCA dot sign (brain)
The middle cerebral artery (MCA) dot sign, also known as the Sylvian fissure sign, is seen on CT of the head
and represents the cross-sectional M2 equivalent of the hyperdense MCA sign. Rather than imaging a length of
middle cerebral artery (typically the M1 segment), the dot sign represents a t...
Article
Medial stripe sign
Medial stripe sign refers to an area of increased lucency at the interface of the medial lung and the mediastinum
in case of medial pneumothorax. A small volume of pneumothorax generally accumulates anteriorly or medially
which can be difficult to detect hence this sign holds a certain significa...
Article
Melting ice cube sign (lungs)
The melting ice cube sign describes the resolution of pulmonary haemorrhage following pulmonary embolism
(PE). When there is pulmonary haemorrhage without infarction following PE, the typical wedge-shaped,
pleural-based opacification (Hampton's hump) resolves within a week while preserving its...
Article
Mercedes-Benz sign (aorta)
The Mercedes-Benz sign can be seen in the aorta in the context of aortic dissection on CT 1. It is seen at three
distinct intimal flaps that have a triradiate configuration similar to the Mercedes-Benz logo (Figure 1). Two of
the three lumens outline by these intimal flaps belong to the false ...
Article
Mercedes-Benz sign (gallbladder)
In the gallbladder, the Mercedes-Benz sign describes a star-shaped pattern of gas-fissuring within gallstones
initially described on an abdominal radiograph 2. Fissures, usually fluid-filled, are present in close to 50% of
gallstones. Less than half of these fissured gallstones contain some amo...
Article
Mickey Mouse appearance
In medical imaging literature, a Mickey Mouse appearance has been given to imaging features that depict that of
Mickey Mouse when viewed from the front. It has been described in the following: anencephaly 2 progressive
supranuclear palsy 1 synonymously with a finger in glove sign the flared ...
Article
Mickey Mouse sign (ultrasound)

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The Mickey Mouse sign is said to represent the normal anatomy of the common femoral artery, common
femoral vein and great saphenous vein on ultrasound at the level just inferior the inguinal crease. See also
Mickey Mouse appearance
Article
Middle cerebellar peduncle sign
The middle cerebellar peduncle (MCP) sign is a feature of a number of conditions, particularly
neurodegenerative diseases, and most commonly associated with fragile X-associated tremor/ataxia syndrome
(FXTAS) although many other conditions are recognised. It represents high T2 signal in the mi...
Article
Moguls of the heart
The 'moguls of the heart' refer to the bulges of the cardiomediastinal contour on frontal chest radiographs. The
cardiomediastinal bulges are likened to skiing moguls (bumps of packed snow on a mountainside sculptured by
turning skis). Awareness of their usual locations and aetiologies is helpfu...
Article
Molar tooth sign (abdomen)
Abdominal molar tooth sign refers to the appearance of contrast media spilled out of the urinary bladder on CT
cystography after extraperitoneal bladder rupture. Contrast flows out of the ruptured bladder, occupying
preperitoneal cavum Retzii and surrounds the bladder in the shape of a molar to...
Article
Molar tooth sign (CNS)
The molar tooth sign refers to the appearance of the midbrain in an axial section in which the elongated superior
cerebellar peduncles give the midbrain an appearance reminiscent of a molar or wisdom tooth. It was initially
described in Joubert syndrome and related disorders (JSRD) 2 but is now...
Article
Mondor sign (foot)
Mondor sign is a sign seen clinically and on CT, and refers to a haematoma that is formed and extends distally
along the sole of the foot 1. Its presence is considered pathognomonic for a calcaneal fracture 1. History and
etymology It was named after Henri Mondor (1885-1962), a French surgeon,...
Article
Monod sign (lungs)
Monod sign (often misspelt Monad sign) simply describes gas that surrounds a mycetoma (most commonly an
aspergilloma) in a pre-existing pulmonary cavity 1-3. It should not be confused with the air crescent sign which
is seen in recovering angioinvasive aspergillosis 4. The air crescent sign her...
Article
Moose head appearance
The moose head appearance refers to the lateral ventricles in coronal projection in patients with dysgenesis of
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the corpus callosum. The cingulate gyrus is everted into narrowed and elongated frontal horns. An alternative
name is the viking helmet sign.
Article
More black sign
The more black sign is a normal finding in lateral chest x-ray, and refers to the gradual increased apparent
radiolucency (blackness) of the vertebral bodies, when proceeding from upper to lower chest. This is due to the
increased proportion of the chest comprised of air containing lungs over di...
Article
Morning glory sign (midbrain)
Morning glory sign of progressive supranuclear palsy (PSP) and multisystem atrophy, not to be confused with
morning glory syndrome, refers to the appearance of the midbrain on axial imaging 1. Graphically this is
identified on a axial image at the level of the midbrain by drawing 1: a horizo...
Article
Morning glory syndrome (eye)
Morning glory disc anomaly (MGDA),also known as morning glory syndrome, is a rare congenital
malformation of the optic nerve which is frequently associated with midline abnormalities of the brain and skull
1. Epidemiology Morning glory disc anomaly is rare and is more commonly found in females...
Article
Mosaic attenuation pattern in lung
Mosaic attenuation is a descriptive term used in describing a patchwork of regions of differing pulmonary
attenuation on CT imaging. It is a non-specific finding, although is associated with the following: obstructive
small airways disease: low attenuation regions are abnormal and reflect decr...
Article
Mosaic pattern of bone
The mosaic bone pattern, also referred to as the jigsaw pattern of bone is seen in Paget disease, where thickened,
disorganised trabeculae lead to areas of sclerosis are interspersed with lucent and more normal bone. See also
Other Paget disease related signs: blade of grass sign tam o' shan...
Article
Mother in law sign
The mother in law sign is perhaps uncharitably (depends on the mother in law I suppose) used to describe
lesions that enhance early during the arterial phase and remain opacified well after the venous phase. The joke is
that a mother in law comes early and stays late. It is most frequently equ...
Article
Motor band sign
The motor band sign is a radiological sign described in amyotrophic lateral sclerosis (ALS). It refers to the
appearance of the cortex on axial GRE and SWI MRI in patients with ALS 1,2. On these sequences, and in the
axial plane, curvilinear bands of low signal may be appreciated within the cor...
Article
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Moulage sign (bowel)
The moulage sign is related to sprue, in particular coeliac disease. It occurs where there is a dilated jejunal loop
with complete loss of jejunal folds 1. It is said to appear like a tube into which wax has been poured. History and
etymology Moulage (French: casting/moulding) is the art of ap...
Article
Mount Fuji sign
Mount Fuji sign is seen on cross sectional imaging and is indicative of a tension pneumocephalus. The sign
refers to the presence of air (pneumocephalus) between the tips of the frontal lobes with a heaped-up appearance
giving the silhouette like appearance of Mount Fuji 1-3. It suggests that ...
Article
M sign (inferior frontal gyrus)
The M sign refers to the characteristic "M" configuration of the inferior frontal gyrus, as it forms (from front to
back) the pars orbitalis, pars triangularis, and, pars opercularis.
Article
Mushroom cap sign
Mushroom cap sign is one of the important signs of deep rectosigmoid endometriosis seen on T2
weighted MRI sequence. It indicates the submucosal involvement in rectosigmoid region. Radiographic
appearance MRI Hypertrophic muscularis propria appears as heterogeneous low signal intensity surrou...
Article
Mushroom sign (pyloric stenosis)
The mushroom sign (also called umbrella sign) is a radiological sign described in pyloric stenosis on barium
examination. This sign refers to the impression made by the hypertrophic pylorus on the duodenal cap. See also
shoulder sign cervix sign of pyloric stenosis target sign of pyloric st...
Article
Naclerio V sign
The Naclerio V sign is a sign described on the plain film in patients with a pneumomediastinum occurring often
secondary to an oesophageal rupture. It is seen as a V-shaped air collection. One limb of the V is produced by
mediastinal gas outlining the left lower lateral mediastinal border. The...
Article
Naked facet sign (vertebral column)
The naked facet sign (also known as the hamburger sign or reverse hamburger bun sign) refers to the CT
appearance of an uncovered vertebral articular facet when the facet joint is dislocated, most often in cases of
locked facet. This CT sign is characteristic of a flexion-distraction injury an...
Article
Napkin-ring sign (heart)

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The napkin-ring sign (heart) is a recently described sign encountered on CT coronary angiogram (coronary
CTA) performed on modern MDCT. It has been shown to possess a high predictive value in predicting future
cardiac events and is considered one of the imaging correlates of an unstable plaque. ...
Article
Neuhauser sign (distal ileum)
Neuhauser sign refers to a soap bubble appearance seen in the distal ileum in cases of meconium ileus, related to
the air mixed with meconium. It may be seen with barium enema if contrast passes beyond the ileocaecal valve
or with small-bowel follow-through. Although classically described with ...
Article
Nightstick fracture
Nightstick fractures are isolated fractures of the ulna, typically transverse and located in the mid-diaphysis and
usually resulting from a direct blow. It is a characteristic defensive fracture when the patient tries to ward off an
overhead blow from an assailant (or local law enforcement offic...
Article
Nodule-in-nodule appearance (liver)
In hepatic imaging, a nodule-in-nodule appearance represents foci of abnormal arterial enhancement within a
liver lesion, in cases of a liver regenerative nodule with a focus of hepatocellular carcinoma or high-grade
dysplastic nodule. It is so called because of the nodular arterial enhancement ...
Article
Non-accidental injuries
Non-accidental injuries (NAI) represent both ethical and legal challenges to treating physicians. Radiologists are
often the first to suspect NAI when confronted with particular injury patterns, and a knowledge of these is
essential if the opportunity to save a child from future neglect is not ...
Article
Northern exposure sign
The northern exposure sign has been described as a high specificity sign in sigmoid volvulus. On a supine
abdominal radiograph, the apex of the sigmoid volvulus is seen above (cranial to) the transverse colon.
Article
Notch sign
There are many so-called notch signs. They include: focal notch in the wall (or tail extending from) a 2nd
branchial cleft cyst between the internal and external carotid arteries peripheral notches in the contour of a
solitary pulmonary nodule (SPN) suggests malignancy thymic notch sign late...
Article
Nubbin sign
Nubbin sign (also called as cystic duct sign) is an important sign in a HIDA scan (cholescintigraphy using
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iminodiacetic acid analogues) that may be seen in cases of gallbladder neck obstruction. The "nubbin" refers to a
small amount of radiotracer activity in the cystic duct, with absence of tr...
Article
Nutmeg liver
A nutmeg liver appearance is due to a perfusion abnormality of the liver usually as result of hepatic venous
congestion. When hepatic veins are congested, contrast is prevented from diffusing through the liver in a normal
manner. This results in a mottled pattern of contrast enhancement in the a...
Article
Obliteration of the retrosternal airspace
Obliteration of the retrosternal airspace is seen in any cause of an anterior mediastinal mass.
Article
Occult fracture
Occult fractures are those that are not visible on imaging, most commonly plain radiographs and sometimes CT,
either due to lack of displacement or limitations of the imaging study. There may be signs of a fracture without
one actually being seen. MRI or nuclear medicine studies are sometimes re...
Article
O'Donoghue unhappy triad
O'Donoghue unhappy triad or terrible triad often occurs in contact sports, such as basketball, football, or
rugby, when there is a lateral force applied to the knee while the foot is fixated on the ground. This produces the
"pivot shift" mechanism. The O'Donoghue unhappy triad comprises three t...
Article
Oesophageal intubation
Oesophageal intubation refers to the incorrect placement of an endotracheal tube in the oesophagus. Within
minutes its consequences can be catastrophic with the seriousness of its outcome depending largely on the
timeliness of its diagnosis. Epidemiology Accidental oesophageal intubation can h...
Article
Omega sign of epiglottitis
The omega sign refers to the thickened aryepiglottic folds and epiglottis seen in epiglottitis, when the larynx is
seen endoscopically or via laryngoscope, and not to the appearance on lateral plain films. CT would show the
finding, but placing a child with epiglottitis supine to CT their neck i...
Article
Oncocalyx
An oncocalyx is a dilated tumour filled renal calyx, typically seen in patients with transitional cell carcinomas of
the renal pelvis.
Article
Onion bulb formation

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Onion bulb formation is seen in hypertrophic neuropathies such as Charcot-Marie-Tooth type 1A (CMT1A) and
chronic inflammatory demyelinating polyneuropathy (CIDP). It is the result of proliferation of Schwann cells
and deposition of collagen 1. Radiographic features MRI The nerve roots appea...
Article
Onion peel sign
The onion peel sign (also called the Cumbo sign or double arch sign) is a feature seen with complicated
pulmonary hydatid cyst in which the gas lining between the endocyst and pericyst has the appearance of an
onion peel. It is pathognomonic for a ruptured hydatid cyst. History and etymology I...
Article
Open ring sign
The open ring sign is a relatively specific sign for demyelination, most commonly multiple sclerosis (MS), and
is helpful in distinguishing between the causes of ring enhancing lesions. Interestingly open ring enhancement is
not seen in neuromyelitis optica (NMO). Radiographic features The en...
Article
Orbital emphysema
Orbital emphysema is the presence of gas within the orbital soft tissues. It is usually due to orbital fractures
communicating with the paranasal sinuses but can be caused by penetrating trauma and infection. It is a common
finding also after orbital or ocular surgery. Location preseptal pos...
Article
Oreo cookie sign (heart)
The Oreo cookie sign refers to the appearance of a pericardial effusion on lateral radiographs of the chest. A
vertical opaque line (pericardial fluid) separating a vertical lucent line directly behind sternum (pericardial fat)
anteriorly from a similar lucent vertical lucent line (epicardial fa...
Article
Owl's eye sign
The owl's eye sign represents bilaterally symmetric circular to ovoid foci of high T2-weighted signals in the
anterior horn cells of the spinal cord and is seen on axial MR imaging. The sagittal corollary is a "pencil-like"
vertical linear high T2-weighted signal extending usually over a number ...
Article
Palla sign
Palla sign is a sign seen on chest radiographs suggestive of pulmonary embolism, usually seen in the acute
setting. Although uncommon, it can be seen along with several other described signs of pulmonary embolus on
chest radiography. Pathology Palla sign describes an enlarged right descending...
Article
Pancake brain
Pancake brain, is the classical sign of alobar holoprosencephaly. It is due to fusion of the cerebral hemispheres
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leaving a single ventricle in its center. It is the most severe form of holoprosencephaly. It is associated with
multiple facial abnormalities. See also pancake vertebra vegetable...
Article
Panda sign (disambiguation)
The humble panda has a few signs to its name: panda sign of the midbrain double panda sign panda sign of
sarcoidosis See also animal and animal produce inspired signs
Article
Panda sign (midbrain)
The panda sign in neuroimaging refers to the appearance of the midbrain, when the red nucleus and substantia
nigra are surrounded by high T2 signal. It is classically seen in Wilson disease, although whenever the white
matter is diffusely abnormal in the region a similar appearance will be perc...
Article
Panda sign (sarcoidosis)
The panda sign of sarcoidosis is a gallium-67 citrate scan finding. It is due to bilateral involvement of parotid
and lacrimal glands in sarcoidosis, superimposed on the normal uptake in the nasopharyngeal mucosa. The
presence of perihilar adenopathy adds the lambda distribution of increased up...
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775 results found
Article
Panzerherz (heart)
Panzerherz (or armoured heart) is a term used to describe the appearance of the heart in calcified constrictive
pericarditis. The pericardium becomes circumferentially thickened with calcification, limiting the ability of the
heart to contract. The rim of dense calcification describes how the h...
Article
Papilloedema
Papilloedema is an ophthalmoscopic diagnosis and refers to swelling of the optic disc. The MRI appearance
relates to the dural anatomy of the optic nerve, which is continuous with the subarachnoid space, thereby
allowing increased intracranial pressure (ICP) to be transmitted to the optic disc. ...
Article
Parrot beak meniscal tear
Parrot beak meniscal tears are a type of oblique meniscal tear which is connected in one plane and displaced in
the other plane. Its appearance on axial images is curved like a crescent and is likened to that of a parrot's beak.
The tear gap has a curved V-shape. Some authors advise that the t...
Article
Patent track sign

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Patent track sign is a finding on color Doppler ultrasound, representing blood traveling along the course a biopsy
needle track. It can occur after a biopsy of any organ, but is more often seen after liver or kidney biopsies.
Radiographic findings linear color Doppler flow along the course of ...
Article
Peaking sign (tension pneumocephalus)
The peaking sign is seen in cross-sectional imaging of the brain suggestive of a tension pneumocephalus. It
represents the frontal lobes being pushed together forming a peak in the midline giving a heaped up appearance
surrounded by air 1. Later, as the frontal lobes are separated they take on t...
Article
Pearl necklace sign
The pearl necklace sign occurs in adenomyomatosis of the gallbladder, on both oral cholecystograms and
MRCP. It represents the contrast / fluid-filled intramural mucosal diverticula (Rokitansky-Aschoff sinuses);
lined up, these are reminiscent of pearls on a necklace. It is synonymous with the C...
Article
Pear-shaped bladder
Pear-shaped (or teardrop-shaped) bladder is one whose normal round or ovoid shape has been extrinsically
compressed to resemble a pear. The pear may be inverted or upright, depending on how the excess pelvic tissue
compresses the bladder. Pathology Aetiology Causes of a pear-shaped bladder in...
Article
Peg-like tonsil (cerebellum)
Peg-like tonsils refer to the CT or MR appearances of pointed cerebellar tonsils on sagittal scans. The may help
distinguish low-lying tonsils from cerebellar tonsillar ectopia due to a Chiari I malformation. The terminology
of caudally displaced tonsils is discussed in the article on cerebell...
Article
Pelvic teardrop
The pelvic teardrop, also known as U-figure, is a radiographic feature seen on pelvic x-rays and results from the
end-on projection of a bony ridge running along the floor of the acetabular fossa. This was shown to be the case
by demonstrating that sawing away this bony plate made the feature d...
Article
Penumbra sign (bones)
The penumbra sign represents a rim of vascularized granulation tissue around a bone abscess cavity that has a
higher T1 signal intensity than the cavity itself 1. It should not be confused with the ischaemic penumbra of
cerebral infarction. The penumbra is isointense to muscle on T1, enhance...
Article
Peribronchial cuffing
Peribronchial cuffing refers to a radiographic term used to describe haziness or increased density around the
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walls of a bronchus or large bronchiole seen end-on, both on plain radiographs and on CT. It is sometimes
described as a "doughnut sign". When viewed tangentially, it can give the appear...
Article
Pericardial calcification
Pericardial calcification usually occurs in patients with a history of pericarditis. Pathology Aetiology uraemia
previous trauma or prior pericarditis later sequelae of rheumatic heart disease malignant pericardial involvement
(e.g. mediastinal teratoma) On chest radiography, location of...
Article
Perilymphatic fistula
A perilymphatic fistula (also known as a labyrinthine fistula) is a pathologic communication between the fluid-
filled space of the inner ear and the air-filled space of the middle ear, most commonly occurring at either the
round or oval window. The primary manifestations of perilymphatic fistu...
Article
Perinephric stranding
Perinephric stranding refers to the appearance of oedema within the fat of the perirenal space on CT or MRI.
While a degree of symmetric bilateral perinephric stranding is common, particularly in the elderly, asymmetric
or unilateral perinephric stranding is an important sign of renal inflammati...
Article
Periportal free gas sign
The periportal free gas sign has been described as being strongly suggestive for upper gastrointestinal hollow
viscus perforation. See also bowel perforation (summary) pneumoperitoneum
Article
Periportal halo
Periportal halo or periportal collar sign is a zone of low attenuation seen around the portal veins on contrast-
enhanced CT or hypoechogenicity on liver US. Periportal halos may occur around the central portal veins or
their peripheral branches and occurs on both sides of the portal triads. Pat...
Article
Perirenal cobweb
Perirenal cobwebs are the presence of prominent perinephric septa. It is best appreciated on CT images.
Pathology The cobweb is considered to be due to engorged venous collaterals or due to oedema and fluid
extravasation into the perirenal space 1. Perirenal cobwebs may be seen in many benign...
Article
Phantom calyx
A phantom calyx is a solitary calyx which fails to opacify with contrast amidst an otherwise well-opacified
pelvicalyceal system. It is due to an intrarenal process which has infiltrated and caused obliteration of the
involved collecting system element. It may be seen in: tumour: especially tr...
Article
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Phemister triad
The triad of Phemister refers to three features seen classically with tuberculous arthropathy: juxta-articular
osteopenia/osteoporosis peripheral osseous erosions gradual narrowing of joint space History and etymology
Named after Dallas Burton Phemister (1882-1951), American orthopaedic sur...
Article
Phrygian cap
Phrygian caps are the most common congenital anatomic variant of the gallbladder. It denotes folding of the
fundus back upon the gallbladder body and is asymptomatic with no pathological significance. Radiographic
findings A Phrygian cap may be identified on ultrasound, multiphase CT/MRI or ch...
Article
Picture frame vertebral body
Picture frame vertebral body is a radiologic appearance in which the cortex of the vertebral body is
thickened. This sign can be seen in patients with Paget disease. It is a result of disorganised new cortical bone
formation after excessive osteoclastic activity causes the resorption of normal...
Article
Piece of pie sign (wrist)
The piece of pie sign refers to an abnormal triangular appearance of the lunate on a PA image of the wrist
representing either lunate dislocation or perilunate dislocation 1,2. A lateral image will help differentiate
whether there is lunate or perilunate dislocation, with lunate dislocation demo...
Article
Pine cone bladder
A pine cone bladder or christmas tree bladder is a cystogram appearance in which the bladder is elongated and
pointed with thickened trabeculated wall. It is typically seen in severe neurogenic bladder with increased
sphincter tone (detrusor sphincter dyssynergia) due to suprasacral lesions (abo...
Article
Pistol grip deformity (hip)
The pistol grip deformity is considered a typical radiographic sign of cam-type femoroacetabular impingement.
The shape of the proximal femur is reminiscent of a flintlock pistol known from old pirate movies. History and
etymology It was first described by American orthopaedic surgeon S David ...
Article
Pitt pit
Pitt pit refers to an oval or round lucency in the anterosuperior aspect of the femoral neck, just distal to the
articular surface. It represents a herniation of synovium or soft tissues into the bone through a cortical defect,
hence the alternate name synovial herniation pit. They are usually a...
Article
Pleural mouse
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A pleural mouse (also known as a fibrin body), is a 1-2 cm mobile rounded clump of fibrin left over after
resolution of a pleural effusion.
Article
Pneumolipohaemarthrosis
Pneumolipohaemarthrosis is the presence of intra-articular gas in a lipohaemarthrosis. It indicates an open intra-

articular fracture.
Article
Pneumothorax in supine projection
A pneumothorax does not display classical signs when a patient is positioned supine for a chest radiograph.
Instead, the pneumothorax may be demonstrated by looking for the following signs: relative lucency of the
involved hemithorax deep, sometimes tongue-like, costophrenic sulcus: deep sulcu...
Article
Pneumothorax (ultrasound)
Pneumothorax is a serious potential consequence of blunt thoracic trauma and, if misdiagnosed, it may quickly
become life-threatening. For a discussion on epidemiology, clinical presentation, pathology, and treatment and
prognosis please see the main pneumothorax article. Radiographic feature...
Article
Polka-dot sign (vertebral haemangioma)
The polka-dot sign is the result of the replacement of the normal cancellous bone by thickened vertical
trabeculae surrounded by fat marrow or vascular lacunae in vertebral intraosseous haemangiomas 2. It is the
axial equivalent of the corduroy sign seen on sagittal and coronal images. On CT the...
Article
Polo Mint sign (venous thrombosis)
The Polo Mint sign is a description given to a venous thrombosis on contrast-enhanced CT imaging. When
viewed in the axial plane, a thin rim of contrast persists around a central filling defect due to thrombus. This
gives an appearance like that of the popular UK mint sweet, the Polo, also refe...
Article
Pooping duck sign
Pooping duck sign indicates the presence of a triquetral fracture, where an avulsed fracture fragment from the
dorsal cortex of the triquetrum projects along the dorsal aspect of the osseous structures of the wrist. In this sign,
the fracture fragment represents the poop dorsal to the duck. The ...
Article
Popcorn calcification
Popcorn calcification refers to amorphous calcifications often with rings and arcs that resemble popped corn
kernels. This type of calcification may be seen in many radiological settings including 1: chondroid lesions (e.g
enchondroma, chondrosarcoma) fibrous dysplasia pulmonary hamartomas d...

Article
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Popcorn calcification within the breast
Popcorn calcification in the breast is the classical description for the calcification seen in involuting
fibroadenomas which, as the name suggests, has a popcorn-like appearance. Pathology A fibroadenoma in the
long run may degenerate and calcify. Initially there are a few punctate periphera...
Article
Porcelain gallbladder
Porcelain gallbladder refers to extensive calcium encrustation of the gallbladder wall. The term has been used to
emphasise the blue discoloration and brittle consistency of the gallbladder wall at surgery. Often an incidental
finding on multiple different modalities, CT can be used to confirm t...
Article
Porcelain left atrium
Porcelain left atrium, also known as coconut left atrium, is a term used when a large part of or the entire left
atrial wall becomes calcified. It can occur as a rare consequence of endocarditis (with underlying rheumatic
heart disease). It has also been described in the setting of end-stage ren...
Article
Positive carpal sign
The positive carpal sign is a useful radiographic sign for the diagnosis of Turner syndrome in association with
the other musculoskeletal manifestations. Radiographic features Abnormality in the shape of the proximal carpal
row in the dorsopalmar radiographs of the wrist and hand (taking in th...
Article
Positive metacarpal sign
In the metacarpal sign, a line drawn along the heads of the 4th and 5th metacarpals will intersect the head of the
3rd metacarpal if shortening is present. The shortened 4th metacarpal is the key to the sign. The sign is positive
in up to 9.6% of normal individuals 3. It is however seen in a va...
Article
Positive PCL line sign
The positive PCL line sign is an indirect sign of anterior cruciate ligament (ACL) tear based on secondary
changes of the posterior cruciate ligament (PCL) on MRI images. A line tangent to the upper border of the PCL
should normally intersect the medullary cavity of the distal femur, if it does ...
Article
Posterior fat pad sign
The posterior fat pad sign is the visualisation of a lucent crescent of fat located in the olecranon fossa on a true
lateral view of an elbow joint with the elbow flexed at a right angle indicating an elbow joint effusion. Normally,
the posterior fat pad will not be seen on this view. In the s...
Article
Posterior pituitary bright spot

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The posterior pituitary bright spot is an MRI feature of the normal pituitary gland. It refers to the intrinsically
high T1 signal of the posterior pituitary thought to be from the storage of vasopressin, which has a T1-shortening
effect 2. It is important to note that a posterior pituitary bri...
Article
Powers ratio
Powers ratio is a measurement of the relationship of the foramen magnum to the atlas, used in the diagnosis of
atlanto-occipital dissociation injuries. The ratio, AB/CD, is measured as the ratio of the distance in the median
(midsagittal) plane between the: basion (A) and the posterior spinola...
Article
Pretzel sign
The pretzel sign is seen on DSA and is indicative of a serpentine aneurysm 1. The sign refers to the sinusoid
configuration of the intra-aneurysmal vascular channel seen in serpentine aneurysms, giving it the appearance of
a pretzel.
Article
Prévost sign (eyes)
The Prévost sign, also known as the Vulpian sign, refers to conjugate ocular deviation in patients with acute
cortical hemiparetic stroke. The direction is variable, depending on the location of the stroke 3. In a hemispheric
stroke, the eyes usually deviate towards the lesion (away from the h...
Article
Pronator quadratus sign
The pronator quadratus sign can be an indirect sign of distal forearm trauma. It relies on displacement of the fat
pad that lies superficial to the pronator quadratus muscle. Radiographic features Plain radiograph On lateral
wrist radiographs, the pronator fat pad normally appears as a thin r...
Article
Pseudocalculus sign (common bile duct)
A pseudocalculus sign is a term coined to describe a mimic of a distally impacted common bile duct (CBD)
stone on MRCP and CT cholangiography. It results from the forceful contraction of the ampulla of Vater with
pouting into the lower end of the CBD. This impression is superiorly rounded and ...
Article
Pseudocavitation (lung)
Pseudocavitation has been described as a well recognised feature of adenocarcinoma in situ / minimally
invasive adenocarcinoma (bronchoalveolar carcinoma) of the lung. It refers to the central bubble-like low
density region seen within a pulmonary nodule on CT.
Article
Pseudodysraphism
A pseudodysraphism refers to the splayed appearance of a normal spine created due to excessive craniocaudal
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angulation during sonographic evaluation. This can erroneously lead to the diagnosis of a spinal neural tube
defect.
Article
Pseudogallbladder sign
Pseudogallbladder sign is a sonographic feature that can be seen in some children with biliary atresia.
Radiographic features Ultrasound Appears as a cystic structure seen in the liver which is confused with
gallbladder in a few cases of biliary atresia. In these patients it is an important f...
Article
Pseudogestational sac
A pseudogestational sac or pseudosac is the concept that a small amount of intrauterine fluid in the setting of a
positive pregnancy test and abdominal pain could be erroneously interpreted as a true gestational sac in ectopic
pregnancy. The sign was originally reported before the use of transv...
Article
Pseudokidney (intussusception)
The pseudokidney of intussusception is an ultrasound finding in some cases of intestinal intussusception. It

refers to the longitudinal ultrasound appearance of the intussuscepted segment of bowel which mimics a kidney.
The fat-containing mesentery which is dragged into the intussusception, co...
Article
Pseudo-omphalocoele
Pseudo-omphalocoele is the spurious sonographic appearance giving an impression of an anterior abdominal

wall defect. Radiographic features Antenatal ultrasound Pseudo-omphalocoele may be seen in: scanning errors
where there is a deformation of the fetal abdomen by transducer pressure and th...
Article
Pseudopneumomediastinum
Pseudopneumomediastinum is the false impression, usually on a chest x-ray, of pneumomediastinum. Correctly

identifying pneumomediastinum is important, but making the diagnosis in error may lead to further unnecessary
investigation and possible treatment. Causes include: Mach band superimposed...
Article
Pseudosubarachnoid haemorrhage
Pseudosubarachnoid haemorrhage describes apparent increased attenuation within the basal cisterns simulating
true subarachnoid haemorrhage. It is usually due to cerebral oedema. Pathology Causes and associations The
most common cause is cerebral oedema where there is a decrease in parenchymal...
Article
Pseudovein sign (bowel)
The pseudovein sign can occur with active gastrointestinal bleeding where contrast extravasation during
angiography may have a curvilinear appearance as it pools in the gastric rugae or mucosal folds of bowel,
mimicking the appearance of a vein. However, contrast in the “pseudovein” persists bey...
Article
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Ptosis
Ptosis (or blepharoptosis) is a drooping or falling of the upper eyelid. Complete ptosis is due to complete
oculomotor nerve palsy. Partial ptosis is due to a dysfunction of the sympathetic pathway leading to paralysis of
Muller muscle. Note that facial nerve paralysis prevents screwing of the...
Article
Puff of smoke sign
The puff of smoke sign describes the characteristic angiographic appearance of tiny
abnormal intracranial collateral vessel networks in moyamoya disease. Progressive narrowing of the
supraclinoid internal carotid arteries and circle of Willis vessels results in extensive small collateral arteria...
Article
Pulmonary plethora
Pulmonary plethora is a term used to describe the appearances of increased pulmonary perfusion on chest
radiographs. It is commonly used in paediatric radiology. Pathology Usually a left-to-right shunt of 2:1 is
required for pulmonary plethora to occur 2,3. Increased pulmonary perfusion occur...
Article
Pulvinar sign (Creutzfeldt-Jakob disease)
The pulvinar sign refers to bilateral FLAIR hyperintensities involving the pulvinar thalamic nuclei. It is
classically described in variant Creutzfeldt-Jakob disease. It is also described in other neurological conditions:
Fabry disease: the hyperintense signal is seen on T1 rather than T2 bila...
Article
Punctate microcalcification within the breast
Punctate microcalcifications in the breast are defined as calcific opacities <0.5 mm in diameter seen within the
acini of a terminal duct lobular unit. Pathology Associations fibrocystic changes skin calcification skin talc
rarely in DCIS: punctate, clustered, segmentally distributed Radi...
Article
Putaminal rim sign
The putaminal rim sign, also known as the putaminal slit sign, is a relatively specific sign of multiple system
atrophy - parkinsonism (MSA-P), and refers to a linear region of high T2 signal surrounding the lateral aspect of
the putamen at 1.5 T MRI. Importantly this appearance can be seen in n...
Article
Putty kidney
A putty kidney refers to a pattern of renal calcification associated with renal tuberculosis conventionally
described on plain radiography. Calcification characteristically is very homogeneous and ground glass-
like, representing calcified caseous tissue 3,4. Premkumar et al. labelled calcificati...
Article
Quad sign
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The quad sign is a static sonographic sign observed in pleural effusion. It consists of four lines representing the
pleura, rib, fluid, and lung. Similar to the sinusoid sign, this sign has a high sensitivity and specificity for pleural
effusion, which - when simple - is itself anechoic.
Article
Raccoon eyes sign (base of skull fracture)
Raccoon eyes sign (or panda eyes in the UK and Ireland) is due to periorbital ecchymosis and is specific for base
of skull fracture of the anterior cranial fossa. However it is not pathognomonic for trauma, and there are several
rare causes described, including metastatic neuroblastoma, Kaposi ...
Article
Rachitic rosary
Rachitic rosary refers to expansion of the anterior rib ends at the costochondral junctions and is most frequently
seen in rickets as nodularity at the costochondral junctions. Differential diagnosis Other causes of this
appearance include: scurvy: the costochondral junction is more angula...
Article
Racing car sign (callosal dysgnesis)
The racing car sign refers to widely spaced lateral ventricles due to agenesis of the corpus callosum with
intervening Probst bundles. Appearances on axial MRI or CT are reminiscent of a Formula One car seen from
above, with the tyres represented by the widely-spaced frontal horns, and the dilat...
Article
Radial bands sign
The radial bands sign refers to linear bands seen on MRI, radiating from the periventricular white matter to the
subcortical region, thought to be specific for tuberous sclerosis 1,2. Pathology The exact pathogenesis of radial
bands is uncertain, but they are thought to relate to dysfunction o...
Article
Radiocapitellar line
The radiocapitellar line is one of the key lines used to assess alignment on the elbow radiograph. It is
particularly useful in the paediatric setting. The rule A line drawn down the neck of the radius should intersect
the capitellum. It is important to ensure that you draw the line down the r...
Article
Radiological signs (gastrointestinal tract)
Radiological signs are described across the disciplines of imaging, including the gastrointestinal tract. Fruit-
inspired, nature-related, and more feature in the list of signs described for a wide array of pathology. How
fascinating are the minds of radiologists work in describing pathology?
Article
Raindrop skull
The appearance of multiple, well-defined lytic lesions (punched out lesions) of various size scattered throughout
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the skull constitutes the raindrop skull appearance of multiple myeloma. This term is applied as an analogy to
rain hitting a surface and splashing, where it leaves a random pattern ...
Article
Ranke complex
Ranke complex is seen in 'healed' primary pulmonary tuberculosis and consists of two components: Ghon lesion:
calcified parenchymal tuberculoma ipsilateral calcified hilar node
Article
Rat bite erosions (gout)
Rat (a.k.a. mouse) bite erosions are seen in gout and refer to punched out erosions with sclerotic and
overhanging margins.
Article
Rat-tail sign (oesophagus)
The rat-tail sign is used to refer to the tapering of the inferior oesophagus in achalasia. The same appearance
(although it is difficult to see the similarity) is also referred to as the bird beak sign (oesophagus).
Article
Renal arterial cut-off sign
Renal arterial cut-off sign, as the name suggests, is an abrupt termination of the contrast-opacified lumen of the
renal artery. It may or may not be associated with contrast extravasation. It is seen in a vascular injury, e.g.
segmental or main renal artery thrombosis or occlusion.
Article
Reverse bat wing pulmonary opacities
Reverse bat wing pulmonary opacities refer to peripheral opacities of the lungs, sparing the perihilar region. It is
a relatively unusual appearance with a relatively narrow differential: chronic eosinophilic pneumonia organising
pneumonia (formerly bronchiolitis obliterans with organising pne...
Article
Reversed halo sign (lungs)
Reversed halo sign, also known as the atoll sign, is defined as central ground-glass opacity surrounded by denser
consolidation of crescentic (forming more than three-fourths of a circle) or ring (forming a complete circle)
shape of at least 2 mm in thickness. It was initially described on high-...
Article
Reverse figure 3 sign
The reverse figure 3 sign (also known as the E sign) is seen on barium swallows in patients with a coarctation of
the aorta and is the medial equivalent of the figure 3 sign seen on plain chest radiographs. It is formed by
prestenotic dilatation of the ascending aorta, indentation of the coarcta...
Article
Reverse target sign (cirrhotic nodules)

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A reverse target sign is a potential ultrasound marker for cirrhotic nodules on ultrasound.It represents central iso-
hyperechogenicity with surrounding hyperechoic rim. This sign is useful to differentiate metastases from
cirrhotic nodules, conversely the target sign is seen with liver metastases.
Article
Ribbon ribs deformity
Ribbon ribs deformity refers to the presence of thinned ribs on image studies. Such findings could be present in
patients with neurofibromatosis type 1 due to the presence of multiple neurofibromas of intercostal nerves. This
deformity is also described in osteogenesis imperfecta 1 Edwards s...
Article
Rice grain calcification
Rice grain calcification is characteristic of infection with Taenia solium (cysticercosis); when the inflammatory
response of the host kills the larval cysts (cysticerci), they undergo granulomatous change and become calcified.
Radiographic features Ovoid flecks of calcification resembling gra...
Article
Right posterior hepatic notch sign
The right posterior hepatic notch sign is a sharp indentation of the normally smooth posterior right hepatic lobe
margin. It is associated with cirrhosis, although the mechanism is not entirely clear. It has been suggested that
this may be an indication of relative caudate lobe hypertrophy and d...
Article
Rigler notch sign
The Rigler notch sign refers to an indentation in the border of a solid lung mass, which is thought to represents a
feeding vessel, thus suggesting the presence of a bronchial carcinoma 1. However, this sign is also observed in
other conditions, including granulomatous infections, and its differ...
Article
Rigler sign
The Rigler sign, also known as the double wall sign, is seen on a radiograph of the abdomen when the air is
present on both sides of the intestine, i.e. when there is air on both the luminal and peritoneal side of the bowel
wall. Pneumoperitoneum may be a result of perforation or, recent instru...
Article
Rigler triad
Rigler triad consists of three findings seen in gallstone ileus: pneumobilia small bowel obstruction ectopic
gallstone, usually in the right iliac fossa History and etymology It is named after Leo George Rigler, American
radiologist (1896-1979) 1. Practical points Rigler triad should not ...
Article
Rim sign in chronic hydronephrosis
The rim sign can be seen in association with chronic hydronephrosis. In patients with chronic
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hydronephrosis, in all forms of contrast-enhanced imaging of the obstructed kidney, enhancement may occur in
the residual, but markedly atrophic, renal parenchyma, surrounding the dilated calyces and ...
Article
Rim sign in pulmonary infarction
The rim sign in pulmonary infarction is seen on PET-CT with very mild peripheral continuous FDG uptake and
the complete absence of central uptake. This is a different appearance to that seen in lung abscesses or necrotic
tumours, whereby the peripheral FDG-avidity is marked. History and etymolo...
Article
Rim sign in renal vascular compromise
Rim sign in renal vascular compromise is seen in major renal vascular compromise. It can be seen in: renal
artery obstruction from embolism, thrombosis or dissection renal vein thrombosis acute tubular necrosis
Radiographic features At contrast-enhanced CT or MRI, a thin (1-3 mm) rim of su...
Article
Rim sign of avascular necrosis
The rim sign of avascular necrosis (AVN) comprises a high T2 or intermediate T1 signal line sandwiched
between two low signal lines, and represents fluid between the sclerotic borders of an osteochondral fragment,
and implies instability (stage III). The rim sign should not be confused with the...
Article
Rind sign (bones)
The rind sign is used when a lesion is surrounded by a layer of thick, sclerotic reactive bone (i.e. a rind) and is
suggestive of fibrous dysplasia. The classic rind sign is most commonly seen in the proximal femur.
Article
Ring of fire sign (adnexa)
The ring of fire sign, also known as ring of vascularity, signifies a hypervascular lesion with peripheral
vascularity on colour or pulsed Doppler examination of the adnexa due to low impedance high diastolic flow 1.
This sign can be seen in: corpus luteum cyst (more commonly) ectopic pregnan...
Article
Rings and arcs calcification
Rings and arcs calcification is characteristic of chondroid lesions, such as enchondromas and chondrosarcomas.
It is due to endochondral mineralisation of multiple hyaline cartilage nodules and is similar to popcorn
calcification, which has rings and arcs on the background of more amorphous calc...
Article
Ring shadow (disambiguation)
Ring shadows are radiographic signs seen on either chest x-rays or on upper gastrointestinal fluoroscopy: ring
shadow (chest) ring shadow (abdomen)
Article
Roberts sign
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Roberts sign refers to the presence of a gas shadow within the heart or the greater vessels, in cases of fetal death
in utero. It is a rare sign caused by postmortem blood degeneration, usually seen 1-2 days after death; and may
be seen as early as 12 hours. History and etymology First describ...
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775 results found
Article
Rokitansky nodule
A Rokitansky nodule or dermoid plug refers to a solid protuberance projecting from an ovarian cyst in the
context of a mature cystic teratoma. It often contains calcific, dental, adipose, hair, and/or sebaceous components
1. This region has the highest propensity to undergo malignant transformat...
Article
Rolling stone sign
The rolling stone sign refers to the presence of gallstones within the gallbladder that are mobile when the patient
moves. Small gallstones can sometimes be difficult to diagnose due to the absence of posterior shadow artefact
but the presence of a rolling stone sign increases the confidence of...
Article
Romana sign (Chagas disease)
Romana sign, also known as chagoma, refers to periorbital swelling, palpebral oedema and conjunctivitis seen 1-
2 weeks following infection with Trypanosoma cruzi (causative agent in Chagas disease). Romana sign is
associated with ipsilateral regional lymphadenopathy. History and etymology I...
Article
Romanus lesion
The Romanus lesion represents an early finding in inflammatory spondyloarthropathies, such as ankylosing
spondylitis and enteropathic arthritis, and appears as irregularity and erosion involving the anterior and posterior
edges of the vertebral endplates 1. Healing response to these inflammatory...
Article
Rosary sign (gallbladder)
The rosary sign is a CT finding in adenomyomatosis of the gallbladder. It is formed by the enhanced
proliferative mucosal epithelium, with the intramural diverticula surrounded by the unenhanced hypertrophied
muscle coat of the gallbladder. The rosary sign is similar to the pearl necklace sign.
Article
Rose-thorn ulcers
Rose-thorn ulcers or rose-thorn appearance refers to deep penetrating linear ulcers or fissuring typically seen
within stenosed terminal ileum with a thickened wall. They appear as thorn-like extraluminal projections on
barium studies and this appearance is one of the typical signs of Crohn dise...
Article
Rugger-jersey spine
Rugger-jersey spine describes the prominent subendplate densities at multiple contiguous vertebral levels to
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produce an alternating sclerotic-lucent-sclerotic appearance. This mimics the horizontal stripes of a rugby jersey.
This term and pattern are distinctive for hyperparathyroidism. Pathol...
Article
Saber-sheath trachea
Saber-sheath trachea refers to diffuse coronal narrowing of the intrathoracic portion of the trachea with the
concomitant widening of the sagittal diameter. It is not uncommon and is pathognomonic for chronic obstructive
pulmonary disease (COPD) 1. The sagittal:coronal diameter is over 2:1 2 a...
Article
Saber sign in pneumobilia
The saber sign refers to a pattern of gas distribution seen in supine abdominal radiographs of patients with
pneumobilia. A sword-shaped lucency is apparent in the right paraspinal region of the upper abdomen
representing arching gas extending from the common bile duct into the left hepatic duc...
Article
Sack of marbles sign
The sack of marbles sign refers to aggregations of multiple small globules of fat within a cyst mimicking marble
spheres within a sack. They appear hyperechoic on ultrasound, fat attenuation on CT, and high signal on T1WI
and T2WI on MRI. It is considered highly suggestive of a dermoid cyst 1.
Article
Saddle pulmonary embolism
Saddle pulmonary embolism commonly refers to a large pulmonary embolism that straddles the bifurcation of
the pulmonary trunk, extending into the left and right pulmonary arteries. If large enough, it can completely
obstruct both left and right pulmonary arteries resulting in right heart failur...
Article
Sail sign (elbow)
The sail sign on an elbow radiograph describes the elevation of the anterior fat pad to create a silhouette similar
to a billowing spinnaker sail from a boat. It indicates the presence of an elbow joint effusion. The anterior fat
pad is usually concealed within the coronoid fossa or seen parall...
Article
Sail signs
There are numerous sails signs in radiology, where a normal structure is displaced or a pathology creates the
appearance of a sail: elbow sail sign: the raised anterior fat pad on an elbow radiograph thymic sail sign: normal
thymus on a paediatric chest radiograph spinnaker-sail sign (angel w...
Article
Salad oil sign
Salad oil sign, also referred to as the droplet sign, is characterised by small rounded high T2 signal foci within a
breast implant on MRI studies and represents water droplets or small amounts of gas within the silicone. It also
can be characterised as hypointense foci on the water-suppressed s...

Article
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Salt and pepper sign
The salt and pepper sign is used to refer to a speckled appearance of tissue. It is used in many instances, but
most commonly on MRI. Please note that pathologists also use the term. Differential diagnosis Vascular tumours
Used to describe some highly vascular tumours which contain foci of ha...
Article
Salt and pepper sign (skull)
Salt and pepper sign or pepper pot skull refers to multiple tiny well-defined lucencies in the calvaria caused by
resorption of trabecular bone in hyperparathyroidism. There is a loss of definition between the inner and outer
tables of the skull and a ground-glass appearance as well as spotty de...
Article
Sandwich sign (Marchiafava-Bignami disease)
Sandwich sign of Marchiafava-Bignami disease is described as the appearance due to the involvement of central
layers of the corpus callosum. T2 and FLAIR hyperintensities are seen in the central region of body and
splenium of corpus callosum with sparing of peripheral dorsal and ventral layers ...
Article
Sandwich sign (mesentery)
A sandwich sign, sometimes known as a hamburger sign, refers to a mesenteric nodal mass, either para-aortic or
not, giving an appearance of a hamburger. Confluent lymphadenopathy on both sides of the mesenteric vessels
gives rise to an appearance described as the sandwich sign 2. The sign is sp...
Article
Sandwich vertebral body
Sandwich vertebral body is a radiologic appearance in which the endplates are densely sclerotic, giving the
appearance of a sandwich. This term and pattern are distinctive for osteopetrosis. Differential diagnosis the
sandwich vertebrae appearance resembles rugger-jersey spine but can be diffe...
Article
Scalpel sign (spinal cord)
The scalpel sign has been recently described in dorsal thoracic arachnoid web on sagittal MRI spine studies. It
relates to focal distortion of the thoracic cord, appearing anteriorly displaced. The enlarged dorsal CSF space
mimics the profile of a surgical scalpel. It is helpful in distinguishi...
Article
Scimitar sign of cystic adventitial disease
Scimitar sign traditionally referred to a catheter angiographic appearance, although it can also be seen on MRA
and CTA. It denotes lateral displacement and stenosis of the popliteal artery in patients with cystic adventitial
disease.
Article
Scottie dog sign (spine)

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The Scottie dog sign refers to the normal appearance of the lumbar spine when seen on oblique radiographic
projection. On oblique views, the posterior elements of the vertebra form the figure of a Scottie dog with: the
transverse process being the nose the pedicle forming the eye the inferior...
Article
Seatbelt sign (abdomen)
The seatbelt sign is both a clinical and radiological sign. It is simply the presence of bruising/abrasions in the
distribution of a seatbelt (i.e. horizontal and/or diagonal) across the abdomen, chest and sometimes neck. A
positive seatbelt sign, in combination with abdominal pain or tenderne...
Article
Segond fracture
Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very
frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL) tear. On the
frontal knee radiograph, it may be referred to as the lateral capsular...
Article
Sentinel clot sign
The sentinel clot sign is a useful CT finding for the evaluation of probable anatomic sites of haemorrhage. On
CT, acute clotted haemorrhage typically has high attenuation (45 to 80 HU), whereas surrounding areas of acute
non-clotted haemorrhage or more chronic haemorrhage have either lower att...
Article
Sentinel loop
A sentinel loop is a short segment of adynamic ileus close to an intra-abdominal inflammatory process. The
sentinel loop sign may aid in localising the source of inflammation. For example, a sentinel loop in the upper
abdomen may indicate pancreatitis, while one in the right lower quadrant may ...
Article
Septal bounce
Septal bounce is a sign of ventricular interdependence on echocardiography, cardiac CT, and cardiac MRI,
manifested by reduced or paradoxical interventricular septal movement during diastole (i.e. initial septal
movement towards and then away from the left ventricle) during early diastole second...
Article
Septal lines in lung
Septal lines, also known as Kerley lines, are seen when the interlobular septa in the pulmonary interstitium
become prominent. This may be because of lymphatic engorgement or oedema of the connective tissues of the
interlobular septa. They usually occur when pulmonary capillary wedge pressure re...
Article
Sergeant stripes sign (cerebellum)
The sergeant stripes sign refers to the oblique direction of the cerebellar tonsillar folia a feature sometimes
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visible in cases of Chiari I malformation on sagittal imaging. It is unclear which insignia this is meant to
represent as the direction of the chevrons depends on nationality. For exam...
Article
Seurat spleen
Seurat spleen is an angiographic appearance seen following blunt trauma to the spleen. Multiple small punctate
regions of intraparenchymal contrast extravasation lead to a spotted appearance. History and etymology The
term refers to a likeness between the angiographic appearance and the artwor...
Article
Shading sign (endometrioma)
Shading sign is an MRI finding typically seen in an endometrioma. It may also be seen with some endometrioid
tumours (e.g endometrioid carcinoma of the ovary) It helps to distinguish endometriomas from other blood-
containing lesions (e.g. haemorrhagic corpus luteum cysts), with a sensitivity of...
Article
Shagreen patch
A shagreen patch is a subepidermal collagenous connective tissue naevus, also known as a collagenoma,
associated with tuberous sclerosis. The overlying skin may be discoloured with obvious pours, giving the
appearance of orange peel. These lesions are most commonly found in the lumbosacral regio...
Article
Shepherd crook deformity
A shepherd crook deformity refers to a coxa varus angulation of the proximal femur, classically seen in femoral
involvement by fibrous dysplasia, although may be seen in other disorders such as Paget disease of bone and
osteogenesis imperfecta. History and etymology The shape of the proximal f...
Article
Shifting granuloma sign
Shifting granuloma sign refers to a shift in the location of a parenchymal lesion visible on prior films that may
be seen in the presence of atelectasis. For example, this occurs when a calcified granuloma is present in a lung
and a significant parenchymal collapse "shifts" it from one location...
Article
Shiny corner sign (ankylosing spondylitis)
The shiny corner sign is a spinal finding in ankylosing spondylitis, representing reactive sclerosis secondary to
inflammatory erosions at the superior and inferior endplates (corners on lateral radiograph) of the vertebral
bodies which are known as Romanus lesions. Eventually, the vertebral bod...
Article
Shmoo sign
Shmoo sign refers to the appearance of a prominent, rounded left ventricle and dilated aorta on a plain AP chest
radiograph giving the appearance of Shmoo, a fictional cartoon character in the comic strip Li'l Abner, which
first appeared in 1948. This sign is indicative of left ventricular enlar...

Article
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Shortening of the cervical canal
Shortening of the uterine cervical canal as the name implies refers to an abnormal shortening of the uterine
cervical length. It is considered a sign of cervical incompetence in pregnancy and can lead to premature delivery.
Pathology Aetiology primary (i.e. congenital/idiopathic) secondary ...
Article
Shoulder sign of pyloric stenosis
The shoulder sign of pyloric stenosis is seen during barium examination and refers to the bulging of the
hypertrophied pyloric muscle into the lumen of the antrum. It is closely related to the cervix sign of pyloric
stenosis. See also cervix sign of pyloric stenosis target sign of pyloric s...
Article
Shred sign (lungs)
Shred sign is a static sonographic sign observed in lung consolidation. The deeper border of consolidated lung
tissue that makes contact with the aerated lung is shredded and irregular. This sign is not seen in massive
translobar consolidation in which it is more difficult to appreciate the deep...
Article
Sigmoid kidney
A sigmoid kidney is an uncommon variant of the horseshoe kidney. Whereas the typical horseshoe kidney is
fused only at the lower poles, in a sigmoid kidney both the upper and the lower poles are fused 1.
Article
Signal flare phenomenon
The signal flare phenomenon is a useful sign to identify active bleeding in a liquefied haematoma with
haematocrit effect on dynamic CT scan images. When active arterial haemorrhage is present in a liquefied
haematoma that has a haematocrit effect, a signal flare phenomenon may be seen as a lin...
Article
Signet ring sign
The signet ring sign is seen in bronchiectasis when the dilated bronchus and accompanying pulmonary artery
branch are seen in cross-section. The bronchus and artery should be the same size, whereas in bronchiectasis, the
bronchus is markedly dilated. The signet ring analogy has also been applie...
Article
Signs article structure
Signs are numerous in radiology and typically relate to a specific appearance or feature that is reminiscent of an
object. The aim of a named sign is to help recognise or understand a specific imaging appearance (e.g. racing car
sign of corpus callosal dysgenesis). The most important signs are t...
Article
Signs of pulmonary embolus on chest radiography

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There are several described signs of pulmonary embolus on chest radiography which are suggestive of this
diagnosis. None are pathognomonic and need to be interpreted with caution with close regard to the clinical
presentation. Chang sign Fleischner sign Hampton hump (strictly a sign of pulmon...
Article
Silhouette sign (x-rays)
Silhouette sign is somewhat of a misnomer and in the true sense actually denotes the loss of a silhouette, thus, it
is sometimes also known as loss of silhouette sign or loss of outline sign 4. The differential attenuation of x-ray
photons by two adjacent structures defines the silhouette, e.g...
Article
Sinusoid sign (ultrasound)
The sinusoid sign is a dynamic sonographic sign in M-mode describing the movement line representing the lung
towards the pleural line which is displayed as a sinusoidal pattern. Similar to the quad sign, this sign has a high
sensitivity and specificity for pleural effusion, which is anechoic in ...
Article
Sitting duck appearance (jugular foramen)
The sitting duck appearance denotes the normal anatomical configuration of the jugular foramen: the head of the
duck (pointing backwards on the right side) represents the anteromedial pars nervosa the body of the duck
representing the pars vascularis
Article
Sliver sign (patella)
The sliver sign refers to a curvilinear intra-articular osteochondral fragment in the knee joint on conventional
knee radiographs. In the context of acute knee trauma and in association with joint effusion this sign is highly
predictive of a recent transient lateral patellar dislocation 1. Path...
Article
Small bowel faeces sign
The small bowel faeces sign can be observed on abdominal CT scans. The sign has been described as a finding
specific for small bowel obstruction or another severe small bowel abnormality (e.g. metabolic or infectious
disease). While the reported prevalence of the sign in small bowel obstruction ...
Article
Snake-eye appearance (spinal cord)
Snake-eye appearance refers to symmetric bilateral T1 hypointensity/T2 hyperintensity of the anterior horn of
the grey matter on axial cervical MRI, evocative of a pair of snake's eyes. It can be seen in late phase CT
myelography, an all but forsaken technique, where it is also known as fried e...
Article
Snowcap sign (avascular necrosis)
Snowcap sign or snowcapping is defined as the appearance of dense sclerosis over the head of humerus or femur
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in cases of avascular necrosis as seen on plain radiographs, which resembles a snowcapped mountain.
Article
Snowman sign (pituitary macroadenoma)
Snowman sign in neuroimaging refers to the configuration of many pituitary macroadenomas. As they are soft
tumours they are indented by the diaphragma sellae giving them a snowman configuration (or "figure 8" or
"dumbbell" configuration). This feature helps in differentiating these tumours from ...
Article
Snowman sign (total anomalous pulmonary venous return)
Snowman sign refers to the configuration of the heart and the superior mediastinal borders resembling a
snowman. This is seen in total anomalous pulmonary venous return (TAPVR) type I (supracardiac type). It is an
abnormality of the fetal circulation wherein the entire pulmonary venous flow is ...
Article
Snowstorm sign (complete hydatiform mole)
Snowstorm sign in obstetric imaging is classically seen in complete hydatiform mole. It is characterised by the
presence of many hydropic villi which gives the ultrasonographic appearance of a central heterogeneous mass
having a solid, hyperechoic area and interspersed with a multitude of cystic...
Article
Snowstorm sign (disambiguation)
Snowstorm sign may refer to: snowstorm sign: complete hydatiform mole (ultrasound) snowstorm
sign: extracapsular breast implant rupture (ultrasound) snowstorm sign: thyroid pulmonary metastases (chest
radiograph)
Article
Snowstorm sign (extracapsular breast implant rupture)
Snowstorm sign on breast ultrasound imaging represents the presence of free silicone droplets mixed with breast
tissue giving a characteristic heterogeneous echogenic appearance with the dispersion of the ultrasound beam. It
is considered the most reliable sign of extracapsular breast implant ru...
Article
Soft tissue rim sign
The soft-tissue rim sign is used to distinguish a ureteric calculus from a phlebolith. The former appears as a
calcific density with a surrounding rim of soft tissue which represents the oedematous ureteric wall. Phleboliths
on the other hand usually have imperceptible walls (although up to 8% m...
Article
Sonographic halo sign
Sonographic halo sign is used in a number of situations. They include: hypoechoic halo sign (also known as
target or bull's eye sign) in liver metastases: used in hepatobiliary imaging, is a concerning feature for malignant
lesion if the lesion is a hyperechoic liver lesion 1,2 ultrasound halo...
Article
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Sonographic Murphy sign
Sonographic Murphy sign is defined as maximal abdominal tenderness from pressure of the ultrasound probe
over the visualised gallbladder 1,2. It is a sign of local inflammation around the gallbladder along with right
upper quadrant pain, tenderness and/or a mass 2. It is one of the most importa...
Article
Spade phalanx sign
Spade phalanx sign refers to a characteristic distal phalangeal shape in acromegaly. Radiographic features Plain
radiographs The terminal phalangeal tufts become hypertrophied and have a "spade appearance". Other findings
on hand radiography of acromegaly include joint spaces may be minimal...
Article
Spaghetti sign in the bladder
The spaghetti sign refers to the presence of a linear worm like filling defect within a contrast opacified bladder.
This linear filling defect is considered to represent blood clot extruded from the ureter and thereby moulded in
the tubular shape. It is seen in patients with gross haematuria. Pr...
Article
Spalding sign (fetal demise)
The Spalding sign refers to the overlapping of the fetal skull bones caused by collapse of the fetal brain. It
appears usually a week or more after fetal death in utero. This finding was originally described by Alfred Baker
Spalding (1874-1942), an American obstetrician 2, on abdominal radiogr...
Article
Spilled teacup sign (wrist)
The spilled teacup sign describes abnormal volar displacement and tilt of a dislocated lunate on lateral
radiographs of the wrist 1,2. The convexity of the lunate is no longer in articulation with the distal radius while
the concavity is no longer in articulation with the capitate. It is an impo...
Article
Spinnaker sign (mediastinum)
The spinnaker sign (also known as the angel wing sign) is a sign of pneumomediastinum seen on neonatal chest
radiographs. It refers to the thymus being outlined by air with each lobe displaced laterally and appearing like
spinnaker sails. This is distinct from the sail sign appearance of the nor...
Article
Split hand sign
The split hand sign is a clinical sign classically seen in amyotrophic lateral sclerosis (ALS) and refers to loss of
pincer grasp due to preferential wasting of the thenar eminence (abductor pollicis brevis and first dorsal
interosseous muscle) with relative preservation of the the hypothenar em...
Article
Split pleura sign (empyema)

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The split pleura sign is seen with pleural empyemas and is considered the most reliable CT sign helping to
distinguish an empyema from a peripheral pulmonary abscess (see empyema vs pulmonary abscess) 1,2. The
sign results from fibrin coating both the parietal and visceral surfaces of the pleu...
Article
Spoke wheel sign (meningioma)
The spoke wheel sign refers to the pattern of vessels coursing through meningiomas, when seen in cross-
section. It is the result of the same phenomenon which results in the sunburst pattern (vessels seen from the side
rather than in cross-section). Terminology A similar appearance also referr...
Article
Stack of coins sign (bowel)
Stack of coins sign refers to the appearance of small bowel folds that are smoothly and uniformly thickened 1.
The margins between the folds are sharply delineated and the arrangement of clearly demarcated parallel folds is
likened to a stack of coins or a picket fence. This sign is distinct fro...
Article
Staghorn calculus (kidney)
Staghorn calculi, also sometimes called coral calculi, are renal calculi that obtain their characteristic shape by
forming a cast of the renal pelvis and calyces, thus resembling the horns of a stag. For a general discussion of
renal calculi please refer to nephrolithiasis. Epidemiology Stagh...
Article
Stag's antler sign (lungs)
The stag's antler sign refers to upper lobe pulmonary venous diversion (cephalisation) in pulmonary venous
hypertension or pulmonary oedema as seen on frontal chest radiograph. The prominence of upper lobe
pulmonary veins resemble a stag's antlers. It is the earliest sign of pulmonary venous hy...
Article
Starfield pattern (fat embolism)
A starfield pattern has been described as being typical of DWI imaging of patients with cerebral fat
embolism1,2. Although the term is closely linked to the diagnosis of fat embolism, it should be noted that such
an appearance is merely the result of very numerous microemboli. As such a similar ...
Article
Starry sky appearance (ultrasound)
A starry sky appearance refers to a sonographic appearance of the liver parenchyma in which there are bright
echogenic dots throughout a background of decreased liver parenchymal echogenicity. Although usually
associated with acute hepatitis, this sign has been found to have poor sensitivity and...
Article
Steeple sign (trachea)
The steeple sign, also called the wine bottle sign, refers to the tapering of the upper trachea on a frontal chest
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radiograph reminiscent of a church steeple. The appearance is suggestive of croup, which should be obvious
clinically. A corresponding lateral x-ray would show narrowing of the subg...
Article
Steinberg sign (Marfan disease)
The Steinberg sign, also known as the thumb sign, is one of the clinical examination tests for Marfan disease in
the hands. It is a clinical test in which the tip of the thumb is visible medial to the little finger when it is clasped
in the clenched hand. See also thumb sign (disambiguation)
Article
Steinstrasse
Steinstrasse [stīn′shtra-se] is the German word for "stone street", describing a possible complication of
extracorporeal shock wave lithotripsy (ESWL) for urinary tract calculi, wherein a column of stone fragments
forms that blocks the ureter. Incidence Steinstrasse usually develops 1 day to 3...
Article
Stener lesion
Stener lesions are seen in the context of a torn ulnar collateral ligament of the thumb's metacarpophalangeal joint
(gamekeeper's thumb). Pathology Normally, the ulnar collateral ligament lies deep to the adductor pollicis
tendon. A Stener lesion is characterised by slippage of the torn end o...
Article
Stepladder sign (disambiguation)
Stepladder sign may refer to: intracapsular breast implant rupture (ultrasound) gas-fluid levels in obstructed
small bowel (erect abdominal radiograph)
Article
Stepladder sign (intracapsular breast implant rupture)
The stepladder sign is a sonographic sign indicating an intracapsular breast implant rupture. It is considered the
most reliable ultrasonographic finding in silicone gel breast implant intracapsular rupture. It is identified as
multiple, discontinuous, parallel, linear echoes in the lumen, and i...
Article
Stepladder sign (small bowel obstruction)
Stepladder sign represents the appearance of gas-fluid distended small bowel loops that appear to be stacked on
top of each other, typically observed on erect abdominal radiographs in the setting of small bowel obstruction.
Article
Stierlin sign (tuberculosis of ileocaecal junction)
The Stierlin sign refers to repeated emptying of the caecum, seen radiographically as barium remaining in the
terminal part of the ileum and in the transverse colon. This occurs due to irritation of the caecum caused by M.
tuberculosis. It is not specific for tuberculosis and can also be seen in...
Article
Stipple sign (transitional cell carcinoma)

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The stipple sign refers to the pointillistic end-on appearance on intravenous pyelography or retrograde
pyelography of contrast material tracking into the interstices of a papillary lesion. Because the majority of
transitional cell carcinomas (TCC) have a papillary configuration, the presence of...
Article
Strawberry gallbladder
Strawberry gallbladder refers to the surface appearance (not shape) of the mucosa of the gallbladder due to
multiple small collections of triglycerides and cholesterol esters within the lamina propria of the gallbladder wall
(gallbladder wall cholesterolosis). Strawberry gallbladder represents...
Article
Strawberry skull
Strawberry skull refers to the shape of the head on an antenatal ultrasound. Epidemiology Associations In
general, strawberry skull is considered one of the non-specific 'soft markers' for abnormal fetal development. It
is considered more closely associated with trisomy 18 (Edward syndrome). ...
Article
Striated nephrogram
Striated nephrogram is a descriptive term indicating an appearance of alternating linear bands of high and low
attenuation in a radial pattern extending through the corticomedullary layers of the kidney on iodine-based
intravenous contrast enhanced imaging. It is important to know that a simila...
Article
String of beads sign (renal artery)
The string of beads sign is the description typically given to the appearance of the renal artery in fibromuscular
dysplasia (FMD) but may also be used to describe the appearance of splanchnic arteries in segmental arterial
mediolysis (SAM). It refers to the appearance arising from the stenoses ...
Article
String of pearls sign (disambiguation)
String of pearls sign can refer to: string of pearls sign on an abdominal radiograph of fluid-filled dilated small
bowel loops string of pearls sign on ultrasound in polycystic ovarian syndrome string of pearls sign for
angiographic appearances in fibromuscular dysplasia
Article
String of pearls sign (gastrointestinal)
The string of pearls (or beads) sign can be seen on upright or decubitus abdominal radiographs as well as on CT
in patients with small bowel obstruction, increased intraluminal fluid, and slow resorption of intraluminal gas. It
consists of an obliquely or horizontally oriented row of small gas ...
Article
String sign (artery)
The angiographic string sign, also known as the carotid string sign, refers to the thin string of intravenous
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contrast material distal to a stenotic focus in the internal carotid artery (ICA). Pathology A thin stripe of flow is
caused by decreased pressure and flow distal to the stenosis, whi...
Article
String sign (bones)
The string sign of parosteal osteosarcoma refers to the plain radiographic/CT appearance of a radiolucent
cleavage plane between portions of the tumour and cortex of the affected bone. The tumour stalk becomes more
broad-based with time, obliterating the string sign in later stages. The string ...
Article
String sign (bowel)
The gastrointestinal string sign (also known as the string sign of Kantor) refers to the string-like appearance of a
contrast-filled bowel loop caused its severe narrowing. Originally used to describe the reversible narrowing
caused by spasms in Crohn disease, it is now used for any severe narr...
Article
String sign (disambiguation)
The string sign may refer to: angiographic string sign gastrointestinal string sign string sign of parosteal
osteosarcoma
Article
Stuck temporomandibular joint disc
A stuck disc refers to a temporomandibular joint (TMJ) disc which does not translate anteriorly out of the
mandibular fossa onto the articular eminence, but rather remains (thus "stuck") in the fossa. It is a form of TMJ
dysfunction and is typically associated with restricted range of motion. T...
Article
Subcapsular line sign (intracapsular breast implant rupture)
The subcapsular line sign is a small localised leak from a silicone implant that leads to the formation of a thin
layer of silicone between the implant shell and the fibrous capsule. It represents a minimally collapsed
intracapsular breast implant rupture. It is best appreciated by MRI.
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Article
Subcoracoid triangle sign
The subcoracoid triangle sign refers to obliteration of the fat triangle between the coracohumeral ligament
(CHL) and the coracoid process. It is considered a specific but not sensitive sign for adhesive capsulitis of the
shoulder 1.
Article
Subpleural line
Subpleural line refers to a thin curvilinear opacity, 1-3 mm in thickness, lying less than 1 cm from and parallel to
the pleural surface. It corresponds to: atelectasis of normal lung if seen in the dependent posteroinferior portion
of lung of a patient in the supine position (disappears if pro...

Article
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Sugar coating
The so-called "sugar coating" or zuckerguss (German for sugar icing) is seen in post-contrast images of the brain
and spinal cord in patients with leptomeningeal drop metastases or leptomeningeal carcinomatosis. It is seen
both as a result of CNS involvement from distant primaries as well as dir...
Article
Sulcal effacement
Sulcal effacement is a local secondary sign of mass effect in the cranium. Any lesion exerting mass effect on
brain parenchyma can push adjacent gyri together, thereby displacing the CSF from the sulci. It is greatest at the
site where the cause of the mass effect is located (e.g. tumour, haemo...
Article
Sunburst appearance (bone)
Sunburst appearance is a type of periosteal reaction giving the appearance of a sunburst secondary to an
aggressive periostitis. It should not be confused with the sunburst sign of meningioma vascularity. The sunburst
appearance occurs when the lesion grows too fast and the periosteum does not...
Article
Sunburst sign (meningioma)
The sunburst sign refers to the characteristic vascular supply seen in some meningiomas when seen from the side
(tangential to the dural attachment). It is the result of the same phenomenon which results in the spoke wheel
pattern of vessels (viewed in cross-section, parallel to dural attachment...
Article
Sunset eye sign
The sunset eye sign (also known as the setting sun phenomenon) is a clinical phenomenon encountered in infants
and young children with raised intracranial pressures (seen in up to 40% of children with obstructive
hydrocephalus and 13% of children with shunt dysfunction 1). It consists of an up...
Article
Swallow tail sign (substantia nigra)
The swallow tail sign describes the normal axial imaging appearance of nigrosome-1 within the substantia nigra
on high resolution T2*/SWI weighted MRI. Absence of the sign (absent swallow tail sign) is reported to have a
diagnostic accuracy of greater than 90% for Parkinson disease and dementia ...
Article
Swan neck deformity (fingers)
Swan neck deformity is a deformity of the digits that consists of: hyperextension of the proximal interphalangeal
(PIP) joints compensatory flexion of the distal interphalangeal (DIP) joints Pathology Swan neck deformity is
seen in 3,4: rheumatoid arthritis (classical association) post-tr...
Article
Swirl sign (intracranial haemorrhage)

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The swirl sign refers to the non-contrast CT appearance of acute extravasation of blood into a haematoma, for
example an extradural haematoma or subdural haematoma. It represents unclotted fresh blood which is of lower
attenuation than the clotted blood which surrounds it 1. It is the corollary...
Article
Swischuk line
The Swischuk line is helpful in differentiating pathological anterior displacement of the cervical spine from
physiological displacement, termed pseudosubluxation. Measurement the line is drawn from anterior aspect of
posterior arch of C1 to anterior aspect of posterior arch of C3 the anterio...
Article
Swiss cheese sign (lungs)
The Swiss cheese sign has been used for the appearance on CT of fluid-containing pneumatocoeles, that
typically occur following pulmonary lacerations 1. The pneumatocoeles appear as 'holes' in the lung parenchyma
and hence the description with respect to Swiss-style cheeses (e.g. Emmental), whi...
Article
T1 black holes
T1 black holes are hypointense lesions commonly seen on T1WI in patients with multiple sclerosis, and
indicates the chronic stage with white matter destruction, axonal loss and irreversible clinical outcome. There is
a correlation between the number of black holes and patient positive outcome 3.
Article
T2 dark spot sign
T2 dark spot sign is an MRI appearance of endometriomas seen as a result of chronic haemorrhage. The sign is
useful in differentiating a solitary endometrioma from a functional haemorrhagic ovarian cyst, as both might
show high T1 signal with T2 shading. The T2 dark spot, described in the sign...
Article
Talar beak sign (talus)
The talar beak sign is seen in cases of tarsal coalition, and refers to a superior projection of the distal aspect of
the talus. It is most frequently encountered in talocalcaneal coalition. It is thought to result from abnormal
biomechanic stresses at the talonavicular joint. Differential dia...
Article
Tam o' shanter sign (skull)
The "tam o' shanter" is a Scottish hat, named after the character in Robert Burns' 1 poem of the same name. The
appearances of advanced Paget disease of the skull are similar in appearance to the hat. Paget involvement of
the skull, with widening of the diploic space and an overall enlargement...
Article
Tangential calcium sign
A tangential calcium sign is a sign seen with an aortic aneurysm rupture. The calcified intimal rim is
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discontinuous and is seen to tangentially point away from the aneurysmal lumen. This sign is seen at the point of
breach. There is associated retroperitoneal leakage.
Article
Target sign (choledocholithiasis)
The target sign of choledocholithiasis is a finding seen on contrast-enhanced CT and comprises: central density
within the bile duct: stone surrounding low density: bile or mucosa
Article
Target sign (disambiguation)
There are many bull's eye signs, also referred to as target signs: red bone marrow located in the shaft of long
bone with central yellow marrow on MRI peripheral plexiform neurofibromas on MRI intussusception: see
target sign of intussusception choledocholithiasis: see target sign of choledo...
Article
Target sign (intussusception)
The target sign of intestinal intussusception, also known as the doughnut sign or bull's eye sign. The appearance
is generated by concentric alternating echogenic and hypoechogenic bands. The echogenic bands are formed by
mucosa and muscularis whereas the submucosa is responsible fo the hypoec...
Article
Target sign (pyloric stenosis)
The target sign of pyloric stenosis is a sign seen due to hypertrophied hypoechoic muscle surrounding echogenic
mucosa, seen in pyloric stenosis. This is likened to that of a target. See also antral nipple sign cervix sign of
pyloric stenosis shoulder sign of pyloric stenosis
Article
Target sign (tuberculosis)
The target sign of tuberculosis refers to the bull's eye appearance of some parenchymal tuberculomas involving
the brain (see: CNS tuberculosis) and solid abdominal organs (see: hepatic and splenic tuberculosis) on cross-
sectional imaging. Radiographic features Ultrasound hypoechoic nodules ...
Article
Tattoo sign (mammogram)
The tattoo sign is a feature given to describe dermal calcifications seen on mammography 1. The basis of this
sign is that dermal calcifications maintain fixed relationships to one another which are reproducible with similar
projections at different times. This is in contrast to intramammary cal...
Article
Tau sign
The tau sign represents the appearance of a persistent trigeminal artery on the sagittal plane of an angiogram or
on sagittal MRI images. It resembles the greek letter τ, pronounced 'tau'. Persistent trigeminal artery arises from
the junction between the petrous and cavernous ICA and runs poster...
Article
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Teardrop sign (ankle)
The ankle teardrop sign is one of the radiological signs of an ankle joint effusion. It represents the presence of
excess fluid in the inferior part of the anterior compartment of the ankle. Pathology Aetiology trauma gout
rheumatoid arthritis synovitis septic arthritis Radiographic feat...
Article
Teardrop sign (intracapsular breast implant rupture)
The teardrop sign indicates an uncollapsed intracapsular breast implant rupture and is seen as a small focal
invagination of the implant shell caused by a minimal concealed leak of droplets of silicone outside the shell
where the two membranes contact each other. It is best appreciated by MRI. ...
Article
Teardrop sign (superior mesenteric vein)
The teardrop sign of the superior mesenteric vein is one of the important signs in the local staging of pancreatic
adenocarcinoma. Its importance lies in its diagnostic, as well as prognostic, significance. This sign is used in
assessing the resectability of pancreatic cancer. Radiographic feat...
Article
Tectal beaking (midbrain)
Tectal beaking refers to the fusion of the midbrain colliculi into a single beak pointing posteriorly and
invaginating into the cerebellum. It is seen with a Chiari type II malformation. Terminology The term bird beak
sign is used in a number of other contexts: see bird beak sign (disambiguati...
Article
Telephone receiver deformity
A telephone receiver deformity is a characteristic bowing of the shaft of the long bones, usually the humeri or
femora, seen in thanatophoric dysplasia.
Article
Telltale triangle sign
The telltale triangle sign, also known as the triangle sign or telltale triangle, is a radiographic sign seen on plain
abdominal radiograph that signifies presence of pneumoperitoneum 1. It describes the appearance of a
radiolucent triangle of gas formed between three loops of bowel or between t...
Article
Temporal tap manoeuvre
Temporal tap manoeuvre consists in tapping over the ipsilateral superficial temporal artery while assessing the
carotid bifurcation on Doppler ultrasound aiming to produce a reflected flow in the external carotid artery (ECA)
and thus helping to distinguish which vessel is being assessed: extern...
Article
Tensile gallbladder fundus sign

The tensile gallbladder fundus sign is positive when the gallbladder fundus is seen to bulge into, and distort, the
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anterior abdominal wall and is a feature of acute cholecystitis. It is particularly useful as an early sign of the
condition on CT as it has around a 75% sensitivity and 95% speci...
Article
Tent sign (breast)
The tent sign is a term referring to a characteristic appearance of the posterior edge of the breast parenchyma
when a mass (usually an infiltrating lesion) causes its retraction and forms an inverted "V" that resembles the tip
of a circus tent. The detection of a "tent sign" is facilitated by ...
Article
Terry Thomas sign
The Terry Thomas sign refers to an increase in the scapholunate space on an AP radiograph of the wrist (or
coronal CT). The increased distance indicates scapholunate dissociation (often with rotary subluxation of the
scaphoid) due to ligamentous injury. There is no consensus as to what measureme...
Article
Thimble bladder
Thimble bladder is a descriptive term for extreme fibrosis and contracture of the bladder walls, resulting in a tiny
bladder. The term is usually used to describe changes from advanced genitourinary tuberculosis.
Article
Third mogul sign
The third mogul sign can be seen on frontal chest radiograph in the presence of left atrial enlargement. It refers
to an extra mogul or bump along the upper left cardiac silhouette just below the left main bronchus. The third
mogul sign commonly represents the enlarged left atrial appendage, pa...
Article
Thoracic spine sign (ultrasound)
The thoracic spine sign on lung ultrasound is an indirect indicator of the presence of a pleural effusion or
haemothorax. It represents the visualisation of the vertebral bodies in the thoracic cavity above the diaphragm
which are usually not seen unless there is a fluid collection. Radiograph...
Article
Thoracoabdominal sign
Thoracoabdominal sign, a variation of the silhouette sign, is a frontal chest radiograph sign which helps to
localize a thoracic lesion. Since the posterior costophrenic sulcus is more caudal than the anterior lung, a
thoracic lesion must be posterior if its caudal end is visible below the dome...
Article
Threads and streaks sign
The threads and streaks sign refers to an angiographic appearance of a vascularised tumour thrombus extending
into the ipsilateral renal vein or the inferior vena cava from a renal cell carcinoma. This gives an appearance of
linear, thread-like or string-like appearance of the involved vessel. ...
Article
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Three line sign (common bile duct)
The three line sign refers to an MRI term that describes the appearance of roundworm Ascaris lumbricoides
within the CBD lumen which appears as two hypointense lines representing the worm walls and hyperintense
centre which represents the worm gut. See also biliary ascariasis
Article
Throckmorton sign (pelvis)
Throckmorton sign, also known as John Thomas sign, refers to when the penis points in the direction of
unilateral disease, typically of the pelvis or hip. Throckmorton sign is a slang term used humorously by medical
students and residents. According to the first serious study of the sign publ...
Article
Thrombus fissuration
Thrombus fissuration is a sign of impending rupture of an aortic aneurysm. It reflects blood dissecting into the
intramural thrombus. This sign is observed on contrast-enhanced CT as linear contrast infiltrations from the
aneurysm lumen through the intramural thrombus. Thrombus fissurations exte...
Article
Thumbprinting
Thumbprinting is a radiographic sign of large bowel wall thickening, usually caused by oedema, related to an
infective or inflammatory process (colitis). The normal haustra become thickened at regular intervals appearing
like thumbprints projecting into the aerated lumen. Pathology Aetiology ...
Article
Thumb sign (chordoma)
The thumb sign or thumbing of the pons is described in chordomas as is meant to be relatively specific. It is seen
in midline sagittal projection as a projection of the tumour indenting the pons 1,2. See also thumb sign
(disambiguation)
Article
Thumb sign (disambiguation)
The term thumb sign is used to refer to a number of separate radiological appearances, including: thumb sign
(Marfan disease) - a clinical sign thumb sign (epiglottitis) thumb sign (chordoma)
Article
Thumb sign (epiglottitis)
The thumb sign in epiglottitis is a manifestation of an oedematous and enlarged epiglottis which is seen on
lateral soft-tissue radiograph of the neck, and it suggests a diagnosis of acute infectious epiglottitis. This is the
radiographic corollary of the omega sign 1-3. See also Thumb sign is...
Article
Thurstan Holland fragment

The Thurstan Holland fragment also known as the Thurstan Holland sign is an eponymous radiological sign
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depicting a triangular portion of the metaphysis remaining with the epiphysis in a physeal fracture. This
fragment is one of the tell-tale signs of a type 2 Salter-Harris fracture 1. History ...
Article
Thymic notch sign
The thymic notch sign represents the normal thymus in a newborn on a frontal chest radiograph. Interruption of
the cardiac silhouette forms a notch, which may be seen on either side, but more frequently is seen on the left
side.
Article
Thymic sail sign
The thymic sail sign represents a triangular-shaped inferior margin of the normal thymus seen on a neonatal
frontal chest radiograph. It is more commonly seen on the right side, but can also be bilateral. It is seen in 3-15%
of all cases. This sign should not be confused with the spinnaker sail ...
Article
Thyroid inferno
Thyroid inferno refers to the colour Doppler appearance of the thyroid gland in active Graves disease (inclusive
of variants such as Marine Lenhart syndrome), and consists of multiple small areas of colour flow seen diffusely
throughout the gland representing increased vascularity and arterioven...
Article
Tiger stripe appearance
The tiger stripe appearance refers to the characteristic alternating hypo and hyperintense bands on MRI in
Lhermitte-Duclos disease. This rare cerebellar tumour appears like the coat of a tiger. See also tigroid pattern - in
brain
Article
Tip of the iceberg sign (ovarian dermoid cyst)
Tip of the iceberg sign refers to one of the characteristic appearances of an ovarian dermoid cyst. If there are
echogenic cyst contents of sebum and hair, they cause marked posterior acoustic attenuation so that only the
superficial part of the cyst is seen. Just like an iceberg, you may only b...
Article
Tombstone iliac wings
Tombstone iliac wings, also referred to as Mickey Mouse ears pelvis 1, are an imaging descriptor for the iliac
wings of individuals with achondroplasia. These are seen to be small and squared and have been likened to the
appearance of tombstones or the ears of Mickey Mouse.
Article
Toothpaste sign
The toothpaste sign in spinal imaging represents an extrusion of an intervertebral disc into the epidural space. It
is called after the shape of extruded material relatively to the parent disc in a sagittal plane.
Article
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Tramp-stamp oedema
Tramp-stamp oedema is a colloquial term used by some radiologists to denote posterior lumbar subcutaneous
oedema. The term is used to describe oedema in the distribution seen with lower back tattoos, usually in young
women, which are known pejoratively as tramp-stamps. This oedema is thought t...
Article
Tram-track sign (bone)
The tram-track sign is sometimes seen on delayed bone scan images. They can appear as symmetric linear
increase in tracer accumulation along diaphyseal and metaphyseal surfaces of long bones. Corresponding to
similar periosteal reaction seen on radiographs. Bone scan findings precede radiographi...
Article
Tram-track sign (brain)
Tram-track sign in the brain refers to the parallel calcification of the cortex in patients with Sturge-Weber
syndrome 1. It should not be confused with other tram-track signs elsewhere in the body.
Article
Tram-track sign (chest)
Tram-track sign may be used in chest radiography or CT to denote the thickened non-tapering (parallel) walls of
cylindrical bronchiectasis. It should not be confused with other tram-track signs elsewhere in the body.
Article
Tram-track sign (disambiguation)
Tram-track sign may refer to a variety of appearances characterised by near-parallel lines in a number of
contexts and regions including: tram-track sign (brain): cortical calcification in Sturge-Weber syndrome tram-
track sign (orbit): e.g. optic nerve meningioma tram-track sign (chest): thic...
Article
Tram-track sign (orbit)
Tram-track sign refers to the parallel thickening and enhancement around the optic nerve, and is most frequently
seen in the setting of optic nerve meningioma. It may however also be seen in 1: orbital pseudotumour perioptic
neuritis orbital sarcoidosis oribtal leukemia orbital lymphoma or...
Article
Transient ischaemic dilatation
Transient ischaemic dilatation (TID) is a paradoxical phenomenon seen in myocardial perfusion SPECT
imaging. With severe balanced coronary artery disease, myocardial ischaemia may result in apparent
enlargement of the left ventricular cavity during stress. The cause of this is not entirely cl...
Article
Transmantle sign (brain)
The transmantle sign is an MRI feature of focal cortical dysplasia (FCD), almost exclusively seen in type II focal
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cortical dysplasia (Taylor dysplasia - also known as transmantle cortical dysplasia for this reason). However, it is
not always present, seen in ~45% (range 21-72%) of patients with...
Article
Tree-in-bud sign (lung)
Tree-in-bud sign or pattern describes the CT appearance of multiple areas of centrilobular nodules with a linear
branching pattern. Although initially described in patients with endobronchial tuberculosis, it is now recognised
in a large number of conditions. Pathology Pathogenesis The tree-i...
Article
Trethowan sign
The Trethowan sign is used to diagnose slipped capital femoral epiphysis (also called slipped upper femoral
epiphysis). In this sign, the line of Klein passes above the femoral head. It is best done on both AP and true
lateralcit projections. On the AP view of a normal hip, the Klein line inter...
Article
Triangular cord sign (biliary atresia)
The triangular cord sign is a triangular or tubular echogenic cord of fibrous tissue seen in the porta hepatis at
ultrasonography and is relatively specific for the diagnosis of biliary atresia 1,2. This sign is useful in the
evaluation of infants with cholestatic jaundice, helping in the diffe...
Article
Trident acetabulum
Trident acetabulum is an appearance which can be seen in several skeletal dysplasias 1. It is characterised by
small bony spurs at the medial and lateral acetabular margins with a more subtle central spur, resembling a
trident, the three-pronged spear of classical Greece 1. The trident is most ...
Article
Trident hand
A trident hand is a description where the hands are short with stubby fingers, with a separation between the
middle and ring fingers. The appearance mimics a trident, the three-pronged spear of classical Greece. The
trident is most commonly associated with the sea god Poseidon in Greek mytholo...
Article
Trident sign (CNS)
The trident sign describes the typical appearances of the pons in osmotic demyelination syndrome, whereby the
symmetrical high T2/FLAIR signal abnormality centrally in the pons is shaped like a trident, the three-pronged
spear of classical Greece 1. The trident is most commonly associated with t...
Article
Triple bubble sign
The triple bubble sign is the classic radiographic appearance observed in jejunal atresia 1,2. The appearance is
due to a proximal obstruction caused by the atretric jejunum. It is equivalent to the double bubble sign, but a
third bubble is seen because of proximal jejunal distention.

Article
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Troisier sign
Troisier sign is the clinical finding of a hard and enlarged left supraclavicular node (Virchow node), and is
considered a sign of metastatic abdominal malignancy. Terminology It is sometimes referred to as the Virchow
node, which is the name given by Rudolf Virchow (1821-1902) 6, a German pat...
Article
Trough line sign
The trough line sign is a sign of posterior shoulder dislocation on AP films. In a posterior dislocation, the
anterior aspect of the humeral head becomes impacted against the posterior glenoid rim. With sufficient force,
this causes a compression fracture on the anterior aspect of the humeral ...
Article
Trumpeted internal acoustic meatus sign
A trumpeted internal acoustic meatus (IAM) is an indirect sign of an acoustic schwannoma and is useful in
helping differentiating between one and other cerebellopontine angle entities, especially from a meningioma
which typically does not extend into the meatus 1. It is characterized by widenin...
Article
T sign (obstetrics)
The "T sign" is really the absence of a twin-peak sign (or lambda sign) and is used in ultrasound assessment of a
multifetal pregnancy. It refers to the lack of chorion extending between the layers of the intertwin membrane,
denoting a monochorionic pregnancy. The intertwin membrane comes to an...
Article
Tubal ring sign
Tubal ring sign, also referred to as bagel sign or blob sign, one of the ultrasound signs of a tubal ectopic. It
comprises of an echogenic ring which surrounds an unruptured ectopic pregnancy. It is said to have a 95%
positive predictive value (PPV) for ectopic pregnancy. Differential diagnosis...
Article
Tuberculous dactylitis
Tuberculous dactylitis, also known as spina ventosa, is a rare skeletal manifestation of tuberculosis where the
short tubular bones (i.e. phalanges, metacarpals, metatarsals) are affected. Epidemiology Tuberculous osteitis is
one of the commonest bacterial osteitides. Typically the dactylitis ...
Article
Tulip bulb sign
Tulip bulb sign refers to the characteristic appearance of annuloaortic ectasia as seen on CT angiography. There
is symmetric dilatation of the three sinuses of Valsalva, with extension into the ascending aorta and effacement
of the sinotubular junction. It is seen especially in Marfan syndro...
Article
Tullio phenomenon
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The Tullio phenomenon describes the precipitation of vertigo and nystagmus by a loud noise. Pathology
Aetiology The tympanic membrane and ossicular chain must be intact with a mobile footplate. It may be seen in
several situations: congenital syphilis with a semicircular canal fistula post-...
Article
Turtle back sign
Turtle back sign, also referred as tortoise shell appearance, represents a very characteristic pattern of the
schistosomiasis cirrhotic liver in which calcified fibrotic septa are seen aligned perpendicular to the liver capsule
resembling the turtle's carapace. It is considered pathognomonic for...
Article
Twin-peak sign (twin pregnancy)
The twin peak sign (also known as the lambda (λ) sign) is a triangular appearance of the chorion insinuating
between the layers of the inter twin membrane and strongly suggests a dichorionic twin pregnancy. It is best seen
in the first trimester (between 10-14 weeks) 5. While the presence of a t...
Article
Two-slice-touch rule (knee MRI)
The two-slice-touch rule is a sign on MRI of the knee used to increase the sensitivity of diagnosing meniscal
tears. This rule states a meniscal tear is present if abnormal findings are present on two or more images - these
do not have to be contiguous, e.g. can occur on sagittal and coronal sl...
Article
Unfolded aorta
The term unfolded aorta refers to the widened and 'opened up' appearance of the aortic arch on a frontal chest
radiograph. It is one of the more common causes for apparent mediastinal widening and is seen with increasing
age. It occurs due to the discrepancy in the growth of the ascending aorta...
Article
Upper lobe pulmonary venous diversion
Upper lobe pulmonary venous diversion (cephalisation) reflects elevation of left atrial pressure and can occur
with pulmonary oedema. It produces stag-antler's sign on a frontal chest x-ray. The normal left atrial pressure is
5-10 mmHg. An elevation of left atrial pressure to 10-15 mmHg will re...
Article
Upper T sign
The upper T sign is one of the features useful in identifying the central sulcus of the cerebral cortex on cross-
sectional imaging. It relies on identifying the superior frontal sulcus which intersects the precentral sulcus in a
"T" junction, thus defining the precentral gyrus. The central sulc...
Article
Urachus sign
The urachus sign is a radiographic sign of pneumoperitoneum. It represents the outline of the median umbilical
ligament with free abdominal gas in a supine patient, as seen on a plain abdominal radiograph.
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Article
Ureteric jet
Ureteric jets (or ureteral jets) are the visualisation of the normal physiological periodic efflux of urine from the
distal end of each ureter into the bladder. Physiology When the urine passing down the ureter reaches the
vesicoureteric junction it is forced out into the bladder via a strong...
Article
U sign (central sulcus)
The U sign denotes the characteristic "U" shaped appearance of the subcentral gyrus which surrounds the
inferolateral end of the central sulcus and abuts the lateral (Sylvian) fissure. It has been found, at least in one
study, to be the most reliable anatomical feature to identify the central su...
Article
Vacuum phenomenon in shoulder
Vacuum phenomenon in the shoulder refers to the presence of intra-articular gas in the shoulder joint. It is a very
common occurrence, particularly in external rotation. This can cause circular or linear areas of low signal
intensity on GRE MR images of the shoulder obtained with external rotati...
Article
Vegetable and plant inspired signs
There are many signs in radiology which are vegetable- and plant-inspired, they include: Unprocessed produce
celery stalk anterior cruciate ligament: ACL mucoid degeneration celery stalk metaphysis: osteopathia striata
and congenital rubella infection Christmas tree intestinal atresia cocon...
Article
Veiled right kidney sign
The veiled right kidney sign is a sonographic sign described in pneumoretroperitoneum, most commonly due to
duodenal perforation. It refers to the appearance of the right kidney on transabdominal ultrasound 1-4. On
ultrasound, there is difficulty in obtaining images of the right kidney due to i...
Article
Venous distension sign
The venous distension sign is a finding that may be identified on sagittal imaging of the dural venous sinuses
which is said to have a diagnostic sensitivity and specificity of 94% for intracranial hypotension. The sign is
positive when there is a convex inferior margin of the midportion of the...
Article
Venus necklace
A Venus necklace is a term almost never used, but for the sake of completeness is included here. It is used by
some authors 1 to describe a series of T2 hyperintense lesions on the inferior surface of the corpus callosum in
the midline (callososeptal interface), most frequently seen in multiple ...
Article
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Vertebral body squaring (differential)
Vertebral body squaring refers to the loss of normal concavity of the anterior border. It is seen in a variety of
conditions including: Differential diagnosis Ankylosing spondylitis Ankylosing spondylitis is the most common
cause of vertebral body squaring. It usually involves multiple level...
Article
Vertebral scalloping
Vertebral scalloping is a concavity to the posterior (or less commonly anterior) aspect of the vertebral body when
viewed in a lateral projection. A small amount of concavity is normal, as is concavity of the anterior vertebral
body (see vertebral body squaring). Posterior scalloping Causes of...
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Article
Vertebra plana
Vertebra plana (a.k.a. pancake / silver dollar / coin-on-edge vertebra) is the term given when a vertebral body has
lost almost its entire height anteriorly and posteriorly, representing a very advanced compression fracture. Plural
is vertebrae planae. It can occur in a variety of settings, incl...
Article
Viking helmet appearance
The viking helmet appearance refers to the lateral ventricles in coronal projection in patients with dysgenesis of
the corpus callosum. The cingulate gyrus is everted into narrowed and elongated frontal horns. An alternative
name is moose head appearance.
Article
Waldenström sign (hip)
Waldenström sign is the increased distance between the pelvic teardrop and the femoral head. It is a highly
specific sign of a hip joint effusion. Radiographic features Plain radiograph >11 mm total distance or >2 mm
difference compared to contralateral hip 1,2 measured between the lateral a...
Article
Walking man sign (chest x-ray)
The walking man sign is seen on a lateral chest radiograph and is a sign of left atrial enlargement. It results from
posterior displacement of the left main bronchus such that it no longer overlaps the right bronchus. The left and
right bronchus thus appear as an inverted 'V', mimicking the legs...
Article
Wall-echo-shadow sign (ultrasound)
The wall-echo-shadow sign (also known as WES sign) is an ultrasonographic finding within the gallbladder
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fossa referring to the appearance of a "wall-echo-shadow": a curvilinear hyperechogenic line representing the
gallbladder wall a thin hypoechoic space representing a small amount of bile a...
Article
Wasp-waist sign (spine)
The wasp-waist sign is a radiographic appearance seen in patients with Klippel Feil syndrome. It results from
fusion of the vertebral bodies such that the anteroposterior diameter at the level of the affected discovertebral
joint is smaller than the diameter at the superior and inferior limits o...
Article
Water bottle sign (heart)
The water bottle sign or configuration refers to the shape of the cardiac silhouette on erect frontal chest x-rays in
patients who have a very large pericardial effusion. Typically the effusion has accumulated over many weeks to
months (e.g. in patients with malignancy) and the pericardium has g...
Article
Water-lily sign (hydatid cyst)
The water-lily sign is seen in hydatid infections when there is detachment of the endocyst membrane which
results in floating membranes within the pericyst that mimic the appearance of a water lily. It is classically
described on plain radiographs (mainly chest X-ray) when the collapsed membran...
Article
Watermelon skin sign
The watermelon skin sign refers to diffuse, radiating, streaky areas of low signal intensity in prostate on T2WI in
patients with prostatic tuberculosis 1.
Article
Wave sign
The wave sign refers to the indentation of the normal thymus in young children by the ribs, resulting in a wavy
border.
Article
Weapon and munition inspired signs
Weapon and munition inspired signs include the following with their corresponding pathologic conditions:
bayonet deformity Turner syndrome chondrodysplasia bullet-shaped vertebra mucopolysaccharidosis
achondroplasia cannonball metastases metastases from renal cell carcinoma dagger sign ...
Article
Westermark sign
Westermark sign is a sign of pulmonary embolus seen on chest radiographs. It is one of several described signs
of pulmonary embolus on chest radiographs. Pathology The theory behind the sign is either obstruction of the
pulmonary artery or distal vasoconstriction in hypoxic lung 3. In one stu...
Article
Wheel within a wheel sign (hepatic candidiasis)

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The wheel within a wheel sign describes one of several possible ultrasound findings of hepatic candidiasis. The
finding consists of a round lesion with three layers corresponding to the following histopathological changes 2:
peripheral hypoechoic area (fibrosis) middle hyperechoic area (inflam...
Article
Whirlpool sign (mesentery)
The whirlpool sign of the mesentery, also known as the whirl sign, is seen when the bowel rotates around its
mesentery leading to whirls of the mesenteric vessels. Terminology The term whirlpool sign is used in other
contexts: see whirlpool sign (disambiguation). Radiographic features It is...
Article
Whirlpool sign (ovarian torsion)
The whirlpool sign or whirl sign of ovarian torsion is characterised by the appearances of a twisted ovarian
pedicle seen on US or even on CT. Terminology The term whirlpool sign is used in other contexts: see
whirlpool sign (disambiguation).
Article
White cerebellum sign
White cerebellum sign, also called reversal sign or dense cerebellum sign, is encountered when there is a diffuse
decrease in density of the supratentorial brain parenchyma, with relatively increased attenuation of the thalami,
brainstem and cerebellum. This sign indicates irreversible brain dam...
Article
White matter buckling sign
The white matter buckling sign is helpful in distinguishing an extra-axial intracranial mass from an intra-axial
one, and represents the white matter projecting into gyri being compressed and displaced by the mass, even in
the presence of oedema (which would usually expand gyri, if the mass were...
Article
White pyramid sign (kidney)
The white pyramid sign refers to the CT appearance of the medullary pyramids of the kidney which can be seen
normally on unenhanced CT scans as high-attenuation triangular structures. Bilateral high-attenuation renal
pyramids are an occasional incidental normal finding. Additionally, the unila...
Article
Widened intercondylar notch
A widened intercondylar notch on knee radiographs is a sign associated with: haemophilic arthropathy (most
commonly bilateral) juvenile rheumatoid arthritis (most commonly bilateral) tuberculosis arthropathy (usually
unilateral) 3
Article
Widow's peak hair anomaly
Widow's peak hair anomaly refers to a frontal hairline projection. Epidemiology Associations Aarskog syndrome
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Opitz syndrome Waardenburg syndrome frontonasal dysplasia craniofrontonasal dysplasia Clinical presentation
Prominent V-shaped hairline projection. Ocular hypertelorism might be...
Article
Wimberger ring sign
Wimberger ring sign , often simply just called Wimberger ring, refers to a circular calcification surrounding the
osteoporotic epiphyseal centre of ossification in scurvy, which may result from bleeding. It must not be confused
with Wimberger sign, pathognomonic for congenital syphilis. Histor...
Article
Wimberger sign
The Wimberger sign, also called Wimberger corner sign, refers to localised bilateral metaphyseal destruction of
the medial proximal tibias. It is a pathognomonic sign for congenital syphilis. It must not be mixed up with
Wimberger ring sign seen in scurvy, which is sometimes also confusingly re...
Article
Windsock sign (aortic dissection)
The windsock sign refers to appearances seen in type A thoracic aortic dissections on contrast CT. It results from
intimo-intimal intussusception between the true and false dissected lumens of the thoracic aorta. The altering
density of contrast between the dissection lumens which taper distally...
Article
Windsock sign (duodenal web)
The windsock sign is a typical appearance of a duodenal web (intraluminal duodenal diverticulum) on upper
gastrointestinal contrast series which consists of an intraduodenal barium contrast-filled sac that is surrounded
by a narrow lucent line (web or intraluminal mucosal diaphragm) which is wel...
Article
Winking owl sign (spine)
The (absent) pedicle sign, also called the winking owl sign, occurs on plain film when a pedicle is absent. The
term, winking owl sign, where the missing pedicle corresponds to the closed eye, the contralateral pedicle to the
other open eye, and the spinous process to the beak of the animal on ...
Article
X-marks-the-spot sign (large bowel volvulus)
The X-marks-the-spot is a sign of complete bowel volvulus and refers to the crossing loops of the bowel at the
site of the transition. It has been reported to improve diagnostic confidence in detecting caecal and sigmoid
volvulus. This is in contrast to the split-wall sign which indicates partia...
Article
Yin-yang sign
The yin-yang sign (also known as Pepsi sign) is a radiological sign described in both true and false aneurysms
on various imaging modalities. Radiographic features Ultrasound On Doppler ultrasound, the yin-yang sign
indicates bidirectional flow due to the swirling of blood within the true or...
Article
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Y sign (epidural lipomatosis)
The Y sign refers to a common appearance in lumbar epidural lipomatosis where excess fat in the extradural
space compresses the dural sac into the shape of the letter "Y".
Article
Zebra sign (cerebellum)
The zebra sign has been termed to describe the finding of layering of blood in amongst the folia of the
cerebellum, particularly in the setting of remote cerebellar haemorrhage.1 This type of haemorrhage is
characterised by a streaky pattern, like a zebra's stripes, due to blood spreading in th...
Article
Zebra spleen
Zebra spleen, also referred to as psychedelic spleen or more correctly inhomogeneous splenic enhancement
refers to the transient heterogeneous parenchymal enhancement of the spleen during the arterial or early portal
venous phases of contrast enhancement in CT, MRI, or ultrasound imaging. It is...
Article
Zebra stripe sign (bones)
The zebra stripe sign occurs where children with osteogenesis imperfecta have been treated with cyclical
bisphosphonate therapy, e.g. pamidronate. When the drug is delivered in cycles, dense bone is formed while
treatment is being given. This results in dense stripes across the metaphyses of bon...
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Abnormal bowel wall attenuation patterns

Abnormally eccentric gestational sac

Absent bow tie sign (knee)

Absent nasal bone

Accordion sign (colon)

Ace-of-spades sign (heart)

Air bubble sign (tension pneumocephalus)

Air crescent sign (lung)

Andersson lesions refer to an inflammatory involvement of the intervertebral discs by spondyloarthritis.

8% of patients with ankylosing spondylitis, as detected at radiography. Patholog...

Animal and animal produce inspired signs

Anteater nose sign (foot)

Anterior bronchus sign

Anterior tibial translocation sign

Antral nipple sign

Antral pad sign

Apple core sign (colon)

Apple core sign (femur)

Apple-peel intestinal atresia

Arcuate sign (knee)

Argyll Robertson pupil

Arrowhead sign (caecum)

Atoll sign (liver MRI)

Aubergine sign (penis)

Ball of wool sign (hydatid cyst)

Balloon on a string sign (ureter)

Bare orbit sign (sphenoid wing)

Battle sign (base of skull fracture)

Bat wing 4th ventricle

Bat wing opacities (lungs)

Beak sign (arterial dissection)

Beak sign (pyloric stenosis)

Bear paw sign (kidney)

Big rib sign

Bilateral adrenal gland hyperenhancement

Bird beak sign (disambiguation)

Bird beak sign (oesophagus)

Bird beak sign (right colon)

Bird beak sign (sigmoid colon)

Black turbinate sign (nasal cavity)

Blade of grass sign (Paget disease)

Blend sign (brain)

Bone within a bone appearance

Boomerang sign (knee)

Boomerang sign (splenium)

Bouquet of flowers appearance (medullary sponge kidney)

Bracket sign (pars marginalis)

Bracket sign (pericallosal lipoma)

Breast within a breast sign

Bridging vessel sign

Bright dot sign (atypical liver haemangioma)

Bright rim sign (anterior talofibular ligament injury)

Bright rim sign in dysembryoplastic neuroepithelial tumours

Broken heart sign

Bronchial cut-off sign

Brudzinski sign (meningism)

Bulging fissure sign

Bullet and bodkin sign

Bunch of grapes sign (disambiguation)

Butterfly sign (choroid plexus)