Citation, DOI, disclosures and article data
Citation:
Sharma R, Baba Y, Hanging chin sign. Reference article, Radiopaedia.org (Accessed on 09 Nov 2024) https://doi.org/10.53347/rID-182741
The hanging chin sign, also known as the chin-on-chest sign, is a radiological sign appreciated on plain chest radiographs in a geriatric (≥65 years of age) patient population.
The sign describes when, on a plain chest radiograph, the mandible projects over one or more ribs 1,2. This sign is classically seen on an AP projection 1.
This sign has been shown to be of prognostic significance in a geriatric population 1-3. In geriatric patients presenting to the emergency department or intensive care unit with a positive hanging chin sign on the initial plain chest radiograph, they were more likely to be frail and have a higher mortality 1,2. Similarly, in geriatric patients presenting with a neck of femur fracture, the presence of the hanging chin sign on the initial plain chest radiograph was associated with increased frailty and mortality 3.
Differential diagnosis
neuromuscular weakness causing dropped head syndrome 1
kyphosis (e.g. due to osteoporosis) 1, which when excessively present (i.e. hyperkyphosis) in a geriatric population may also be a predictor for mortality 4
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1. Huijgens A, van Baardewijk L, Keijsers C. The Hanging Chin Sign as a Mortality Predictor in Geriatric Patients at the Emergency Department: A Retrospective Cohort Study. BMC Geriatr. 2022;22(1):95. doi:10.1186/s12877-022-02780-7 - Pubmed
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2. Van Beijnen M, Zegers M, Van Leuken M, PC De Jager C, S Simons K. Association Between the Hanging Chin Sign and Mortality in Critically Ill Patients, a Retrospective Observational Study. Emerg Med. 2018;08(02). doi:10.4172/2165-7548.1000369
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3. Egglestone A, Dietz-Collin G, Eardley W, Baker P. Chin-On-Chest in Neck of Femur Fracture (COCNOF) Sign: A Simple Radiographic Predictor of Frailty and Mortality in Hip Fracture Patients. Injury. 2021;52(6):1494-9. doi:10.1016/j.injury.2020.10.098 - Pubmed
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4. Kado D, Lui L, Ensrud K et al. Hyperkyphosis Predicts Mortality Independent of Vertebral Osteoporosis in Older Women. Ann Intern Med. 2009;150(10):681-7. doi:10.7326/0003-4819-150-10-200905190-00005 - Pubmed
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