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Classical Radiological Signs Explained

Classical radiological signs provide important clues to various medical conditions. Some examples include the "apple core lesion" seen in synovial chondromatosis, "bamboo spine" associated with ankylosing spondylitis, and the "bird's beak" appearance typical of achalasia. Other signs such as the "boot-shaped heart" of Tetralogy of Fallot, "bat's wing" pattern in congestive heart failure, and "cobblestone" texture related to Crohn's disease also have distinct radiological presentations. Proper identification of these classical signs can help clinicians accurately diagnose underlying pathologies.

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Muntaha Javed
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55 views2 pages

Classical Radiological Signs Explained

Classical radiological signs provide important clues to various medical conditions. Some examples include the "apple core lesion" seen in synovial chondromatosis, "bamboo spine" associated with ankylosing spondylitis, and the "bird's beak" appearance typical of achalasia. Other signs such as the "boot-shaped heart" of Tetralogy of Fallot, "bat's wing" pattern in congestive heart failure, and "cobblestone" texture related to Crohn's disease also have distinct radiological presentations. Proper identification of these classical signs can help clinicians accurately diagnose underlying pathologies.

Uploaded by

Muntaha Javed
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd

Classical Radiological Signs:Apple core lesion or Napkin Ring sign: in right hip synovial chondromatosis .

Same
can be viewed in colonic Ca.... seems like eaten apple.

Bamboo Spine: fused spinal segments with their syndesmophytes look, on radiographs,
similar to bamboo stalks. Classically associated with ankylosing spondylitis.

Bird's Beak: noted on Upper GI with contrast, a dilated upper/middle


esophagus with an abrupt taper to exceptionally narrowed lumen, typical of achalasia.

Boot-shaped Heart: due to RVH, the LV is lifted above the edge of the
diaphragm, forming the toe of the boot. Classic for Tetralogy of Fallot.

Bat's Wing/Butterfly: this appearance on CXR is classically associated with CHF


and resultant pulmonary edema.

Cobblestone appearance: this sign is produced on barium studies due to


ulcerative pockets, usually in the terminal ileum, indicative of Crohn's.

Codman's Triangle: a triangle on plain film of extremities that signifies reactive


bone, classically associated with osteosarcoma, or other infectious, hemorrhagic process that causes periosteal elevation.

Coin lesion: solitary pulmonary nodule; may be cancer or granuloma. Cookie Cutter lesions: metastatic lesions to bone cortex, or Paget's. Crescent sign: classic sign of avascular necrosis, femoral head. Egg-on-a-string: a large, ovoid-shaped heart on newborn CXR, classically
signifying complete transposition of the great vessels with intact ventricular septum.

Ground glass: a white-out on CXR, usually PCP pneumonia or ARDS. Hampton's Hump: a peripheral triangle, usually near pleural edges, classically
PE.

Honeycomb lung: used to describe any pathologic process that causes


radiographic appearance of multiple small, thick-walled cystic spaces; e.g. pulmonary fibrosis.

Lead pipe sign: classic narrowing of bowel lumen, with loss of haustraUC.
Napkin Ring sign: see Apple core lesion above; pathology identical, but lumen more narrowed.

Onion-skinning: layered look of periosteum in Ewing's Sarcoma.

Rachitic Rosary: this is a string of beads appearance on x-ray, a thickening


of costochondral margins that is noted in Ricketts (Vit. D Deficiency).

Sail sign: fat pad noted on plain film, indicative of shoulder dislocation. Scotty dog (collar) : on posterior oblique, the lumbar vertebrae look like a
Scottish terrier. The neck is the pars interarticularis, and a break(a collar) noted there indicates spondylolysis.

String sign: thin, slightly irregular shadow in narrowed lumen of ileum,


suggestive of Crohn's.

Silhouette sign: obliteration of cardiovascular silhouette due to adjacent


disease, ie pneumonia, TB, etc.

Stepladder appearance: distended bowel loops, often indicative of obstruction,


usually SBO.

Sunburst appearance: clouds, clumps, and consolidated rays of tissue


emanating from bone cortex, or within bony structures, indicative of osteosarcoma.

Thumb (print) sign: on lateral c-spine, an enlarged epiglottis appears as a


thumb epiglottitis.

Westermarcks sign : abrupt end to a pulmonary vessel, signifying oligemia or


PE

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