Coca-Cola bottle sign (thyroid eye disease)

Dr Ian Bickle et al.

The Coca-Cola bottle sign refers to the appearance of the muscles of the orbit in thyroid eye disease.  The belly of the muscle enlarges with sparing of the tendinous insertion, giving the appearance of the traditional Coca-Cola bottle.

The enlargement of the muscles follows the I'M SLOW format.

The nature of the enlargement is important as it is one of the chief findings to differentiate it from orbital pseudotumor, in which the tendinous insertion is also involved and enlarged, unlike in thyroid eye disease.

Inspired signs

Article information

rID: 23936
System: Head & Neck
Section: Signs
Synonyms or Alternate Spellings:
  • Coke sign
  • Coke bottle deformity
  • Coke deformity

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1: photograph - coca-cola bottle
    Drag here to reorder.
  • Case 1: on MRI
    Drag here to reorder.
  • Figure 2: iIllustration - how the term comes about
    Drag here to reorder.
  • Case 2: on CT
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Case 6
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.