Manta ray sign (bladder)
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The manta ray sign is a radiographic appearance in bladder exstrophy. It describes wide midline separation of the pubic bones simulating the appearance of a manta ray swimming towards you 1. The sacrum and iliac wings recall the manta ray’s head and body, with the widely spaced pubic rami forming its cephalic flaps .
On a plain radiograph consider:
- open book pelvic injuries: the smooth arc of the pelvis outline in bladder exstrophy differentiates it from acquired separation of the pubic symphysis seen in open book pelvic injuries