Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

61 results found
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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
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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...
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Banana sign (cerebellum)

The banana sign is one of the many notable fruit inspired signs. This sign is seen on axial imaging through the posterior fossa of fetuses with associated conditions such as  Chiari II malformation and/or spina bifida. In Chiari II malformation, the banana sign describes the way the cerebellum...
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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...
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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...
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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...
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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...
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Celery stalk (disambiguation)

Celery stalk appearance can refer to the following: celery stalk anterior cruciate ligament celery stalk metaphysis
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Cervix sign of pyloric stenosis

The cervix sign of pyloric stenosis describes indentation of the pylorus into the fluid-filled antrum, seen in pyloric stenosis. See also antral nipple sign target sign of pyloric stenosis shoulder sign of pyloric stenosis
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Copper beaten skull

Copper beaten skull, also known as beaten silver skull or beaten brass skull, refers to the prominence of convolutional markings (gyral impressions on the inner table of the skull) seen throughout the skull vault. Clinical presentation The appearance of a copper beaten skull is associated with...
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Corkscrew sign

The corkscrew sign describes the spiral appearance of the distal duodenum and proximal jejunum seen in midgut volvulus 1. In patients with malrotation and volvulus, the distal duodenum and proximal jejunum do not cross the midline and instead pass in an inferior direction. These loops twist on ...
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Coxa valga

Coxa valga describes a deformity of the hip where there is an increased angle between the femoral neck and femoral shaft.  Pathology Coxa valga is often associated with shallow acetabular angles and femoral head subluxation.  Etiology bilateral neuromuscular disorders, e.g. cerebral palsy ...
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Crescent in a doughnut sign (intestinal intussusception)

The crescent in a doughnut sign refers to the transverse ultrasound appearance of intestinal intussusception, and is a variation of the target sign (which is also known as the doughnut sign) The doughnut is formed by concentric alternating echogenic and hypoechogenic bands. The echogenic bands ...
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Double bubble sign (duodenum)

The double bubble sign is seen in infants and represents dilatation of the proximal duodenum and stomach. It is seen in both radiographs and ultrasound, and can be identified antenatally 2. Pathology Causes include 1,2: congenital obstruction duodenal web duodenal atresia duodenal stenosis...
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Double density sign (osteoid osteoma)

The double density sign, also sometimes clumsily referred to as the hotter spot within hot area sign, is a bone scan sign of an osteoid osteoma. It refers to a central focus of intense uptake (the nidus) within a surrounding lower, but nonetheless increased uptake, rim. See also double densit...
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Double lung point sign (Ultrasound)

The double lung point sign refers to a sharp boundary found between relatively aerated superior lung fields and coalescent "B‐lines" (representing interstitial edema) in the basal lung fields, with a reported sensitivity of 45.6%-76.7% and a specificity of 94.8%-100% 1,3 in diagnosing transient ...
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Double track sign (pyloric stenosis)

The double track sign is a radiological sign described in pyloric stenosis on various imaging modalities.  Barium study Double streaks of barium passing through the narrow pylorus 1. Ultrasound On fluid aided real-time examination, the pyloric fluid is compressed into smaller tracks as it is...
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Doughnut sign (disambiguation)

The doughnut sign can refer to a variety of different signs: doughnut sign (bone) doughnut sign (bowel) crescent in a doughnut sign (bowel)
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Echogenic fetal bowel

Echogenic fetal bowel is an observation in antenatal ultrasound imaging, in which fetal bowel appears to be brighter than it is supposed to be. It is a soft marker for trisomy 21 and has several other associations. When observed, it needs to be interpreted in the context of other associated abno...
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Egg-on-a-string sign (heart)

Egg-on-a-string sign, also referred to as egg on its side, refers to the cardiomediastinal silhouette seen in transposition of the great arteries (TGA). The heart appears globular due to an abnormal convexity of the right atrial border and left atrial enlargement and therefore appears like an ...
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Flat floor of fourth ventricle sign

The flat floor of fourth ventricle sign is useful in detecting a pontine mass and is a sign of mass effect. The normal floor of the fourth ventricle (remember that the floor is anterior) normally slopes upwards towards the midline, with the facial colliculi visible on either side.  It is a non-...
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Fountain sign (acute idiopathic scrotal edema)

The fountain sign is sonographic sign described in acute idiopathic scrotal edema (AISE). It refers to the appearance of the pattern of vascularity seen during transverse color Doppler sonography of the scrotum with both testes together 1. In these transverse views in patients with AISE, marked...
Article

Gage sign

Gage sign is a V-shaped lucent defect at the lateral portion of the epiphysis and/or adjacent metaphysis. It is pathognomonic for Legg-Calve-Perthes disease. It may occur early in the disease and is one of the five indicators of a worse prognosis, which are: Gage sign  calcification lateral t...
Article

Ghost vertebra

Ghost vertebra is a sign, that is generally used synonymously with bone-within-a-bone vertebra, and as such, the causes form a subset of those causing bone within a bone appearance 2: Thorotrast administration: bone within a bone appearance due to temporary growth arrest 1 stress line rickets...
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Harlequin eye deformity

The harlequin eye deformity is characterized by elevation of the superolateral corner of the orbit. It may be seen in unilateral (plagiocephaly) or bilateral (brachycephaly) coronal suture synostosis. History and etymology The term harlequin eye derives from the appearance of the eyes on a har...
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Harrison's sulcus

Harrison's sulcus or Harrison's groove refers to a groove at the lower end of the rib cage seen in young children/infants with abnormally weak bones (e.g. rickets) or chronic respiratory disease (e.g. severe asthma). The lower chest is drawn in with flaring of the rib margin. The exact cause is ...
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Haystack sign (pneumomediastinum)

The haystack sign on chest radiographs in pediatric patients is indicative of pneumomediastinum. The pediatric heart is surrounded above and below with gas, giving it an appearance of a haystack from Monet's paintings. 
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J-shaped sella

A J-shaped sella is a variant morphology of the sella turcica, whereby the tuberculum sellae is flattened, thus forming the straight edge of the "J". The dorsum sellae remains rounded and forms the loop of the "J". Differential diagnosis Differential diagnosis for a J-shaped sella includes 1,2...
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Keyhole sign (posterior urethral valves)

The keyhole sign is an ultrasonographic sign seen in boys with posterior urethral valves. It refers to the appearance of the proximal urethra (which is dilated) and an associated thick-walled distended bladder which on ultrasound may resemble a keyhole.
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Kirner deformity

Kirner deformity is characterized 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...
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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...
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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...
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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 ileocecal valve or with small-bowel follow-through. Although classically described with m...
Article

Non-accidental injuries

Non-accidental injuries (NAI) represent both ethical and legal challenges to treating physicians. Radiologists are often the first to suspect non-accidental injuries when confronted with particular injury patterns, and a knowledge of these is essential if the opportunity to save a child from fu...
Article

PSA density

The PSA density (PSAD), is a calculation performed at diagnosis and is the serum PSA level (ng/mL) divided by the volume of the prostate gland (mL)1. Prostate volume is calculated from TRUS measurements2,3.  Alternatively, PSAD may be calculated using MRI measurements3 of prostate volumes or le...
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 pediatric radiology.  Pathology Usually a left-to-right shunt of 2:1 is required for pulmonary plethora to occur 2,3. Increased pulmonary perfusion occurs...
Article

Pyrexia

Pyrexia (or fever) is a clinical sign, indicated by an abnormally elevated core body temperature, which is defined by several medical societies as ≥38.3°C (≥101°F). The temperature elevation may be persistent or episodic. The commonest cause of fever is infection, in one study of hospital inpati...
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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 angular ...
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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 pediatric 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 ra...
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...
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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

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

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 pressure (seen in up to 40% of children with obstructive hydrocephalus and 13% of children with shunt dysfunction 1).  It consists of an up-...
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

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 radiographs in a supine, cross table lateral or decubitus view that signifies presence of pneumoperitoneum, of any cause 1,2. It describes the appearance of a radiolu...
Article

Thumb sign (epiglottitis)

The thumb sign in epiglottitis is a manifestation of an edematous 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 (or Thurstan Holland sign) is an eponymous radiological sign depicting a triangular portion of the metaphysis remaining with the epiphysis in a physeal fracture. This fragment indicates a type 2 Salter-Harris fracture 1. History and etymology It is named after Cha...
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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

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 characterized 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 appearance has...
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Trident appearance (disambiguation)

The trident appearance (or sign) can refer to a variety of entities: trident acetabulum trident hand trident sign (osmotic demyelination) trident sign (persistent trigeminal artery) History and Entomology The trident is most commonly associated with the sea god Poseidon in Greek mythology ...
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

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

Wimberger ring sign

Wimberger ring sign , often simply just called Wimberger ring, refers to a circular calcification surrounding the osteoporotic epiphyseal center of ossification in scurvy, which may result from bleeding. It must not be confused with Wimberger sign, pathognomonic for congenital syphilis. Histor...
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Wimberger sign

The Wimberger sign, also called Wimberger corner sign, refers to localized 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...
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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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