Manta ray sign (bladder)

Last revised by Ian Bickle on 9 Mar 2020

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 .

Differential diagnosis

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

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1: a manta ray
    Drag here to reorder.
  • Case 1: manta ray sign
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Case 5
    Drag here to reorder.
  • Updating… Please wait.

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

     Thank you for updating your details.