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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