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Coiled catheter sign (ureter)

The coiled catheter sign is sometimes seen in transitional cell carcinoma of the ureter. When a retrograde ureteropyelogram is attempted in the afflicted ureter, the catheter tip is seen to coil in the dilated portion of the ureter distal to the obstruction 1.

Uhthoff phenomenon (multiple sclerosis)

Uhthoff phenomenon refers to the temporary exacerbation (lasting less than 24 hours) of neurological symptoms secondary to increases in body temperature. This phenomenon is experienced by multiple sclerosis patients, though it also occurs in other demyelinating diseases 1. History and etymolog...

Trigonum parietale (azygos lobe)

The trigonum parietale refers to a triangular opacity seen on chest radiograph that correlates with a small piece of extrapleural areolar tissue that lies between the layers of pleura in the fissure of an azygos lobe 1-4. It may be seen at the most superior portion of the azygos fissure and shou...

Pumice stone sign

The pumice stone sign is a recently described distinctive imaging appearance of emphysematous osteomyelitis on CT described as clusters of greater than 3 distinct foci of intramedullary gas with irregularly irregular sizes ranging between 2 and 5 mm with resemblance to surface appearance of pumi...

Blunting of the costophrenic angle

Blunting of the costophrenic angle (also known as blunting of the costophrenic sulcus) is a chest radiograph sign usually indicative of a small pleural effusion. It may be seen on either frontal or lateral erect projections. It has been found that approximately 200 mL pleural fluid needs to be p...

Bird’s nest sign (lungs)

The bird’s nest sign refers to the appearance created by a reverse halo sign with associated irregular and intersecting areas of stranding or irregular lines within the area of ground-glass opacity 1. Both bird's nest sign and reverse halo signs are suggestive of invasive pulmonary fungal infec...

Beak sign (gallbladder)

The beak sign of gallbladder volvulus describes tapering of the distended gallbladder lumen as it transitions to a fulcrum point at the pedicle, resembling a curved beak. Terminology The term bird's beak sign is used in a number of other contexts: see bird beak sign (disambiguation).

Backfill

Backfill refers to intra-articular high signal intensity on T1 weighted images seen in axial spondylarthritis within the sacroiliac joint filling up excavated bone erosions 1. It has been characterized as a complete loss of the cortical bone within the sacroiliac joint at the anticipated locatio...

Iris sign

The iris sign is the imaging appearance of deep medullary venous thrombosis/congestion-related white matter injury in neonates created by fan-shaped, outwards radiating hemorrhages or cytotoxic edema in the subcortical and periventricular cerebral white matter. The appearance resembles the flowe...

Pancake organ (disambiguation)

A variety of organ abnormalities have been described as having an appearance similar to a pancake. pancake adrenal pancake brain pancake kidney pancake vertebra

Braid-like sign (spinal sarcoidosis)

The braid-like sign is an imaging pattern of sarcoidosis spinal cord involvement. It is characterized by a ventral subpial enhancement in the spinal cord.

Tulip sign

The tulip sign is a sonographic clue for in utero diagnosis of severe hypospadias. The configuration of a tulip is given by the severe curvature of the penis in association with the penoscrotal transposition of a bifid scrotum. History and etymology The tulip sign was first described in 2002 ...

Walnut kernel microbleed pattern

The walnut kernel microbleed pattern along with the starfield pattern and corpus callosum diffusion restriction appears to be the most important imaging markers of cerebral fat embolism 1-3. In this pattern, there is a diffuse presence of round microbleeds (punctate focal hypointensities) of si...

P sign

The alphabet P sign, or just P sign, is a sonographic finding in acute epiglottitis. Using point of care ultrasound (POCUS), on a longitudinal view at the level of the thyrohyoid membrane, a P-shaped hypoechogenicity is apparent. The curved portion of the P is formed from the edematous epiglotti...

O sign

The O sign is a radiographic sign described in gastric band slippage. Normally, a correctly-sited laparoscopic gastric band lies such that its anterior and posterior margins are superimposed in the anteroposterior orientation and a oblong morphology is visible on a frontal radiograph. When a g...

Flip-flop renal enhancement

Flip-flop renal enhancement describes when an infarcted renal parenchyma alternates between hypoattenuation during the arterial phase, and hyperattenuation on the delayed phase of a contrast enhanced CT 1,2. Terminology Flip-flop renal enhancement should not be confused with the flip-flop eff...

Guitar pick sign (orbits)

Guitar pick sign refers to conical deformation (tenting) of the posterior ocular globe indicating severely increased intraorbital pressure (orbital compartment syndrome) Presence of a guitar pick sign on imaging is associated with acute and permanent visual damage.

Flail leaflet

Flail leaflet or leaflet flail refers to an abnormally increased leaflet mobility of the atrioventricular valves associated with valvular prolapse and a systolic excursion of the leaflet tip or edge into the atria. Pathology Flail leaflet can be seen in leaflets of the mitral and tricuspid val...

Optic nerve calcification

Optic nerve calcification is a rare radiological finding, with only a short differential diagnosis, many of which have only been described in isolated case reports 1-4. Differential diagnosis optic nerve meningioma optic nerve head drusen idiopathic dural optic nerve sheath calcification ca...

String of pearls sign (watershed infarction)

The string of pearls sign is seen on diffusion-weighted imaging of T2/FLAIR as a series of rounded areas of signal abnormality adjacent to, but separate from, the lateral ventricle. This represents a deep border zone infarct between the penetrating cortical arteries and ascending perforating art...

Bright band sign

The bright band sign is a sonographic sign found in the context of splenic infarction. It consists of highly hyperechoic linear-shaped bands within splenic infarct lesions of different ages 1. Histological examinations of spleens with the sign suggest it might be caused by preserved fibrous tr...

Roesler sign

Roesler sign is the name given to the inferior rib notching seen in coarctation of the aorta. Although by no means pathognomonic, the sign is fairly specific. Although many other causes of inferior rib notching have been recorded most of them are very rare 1. Strictly-speaking it is only called...

Jail bar sign (vertebral hemangioma)

The jail bar sign refers to the vertically striated appearance seen in vertebral hemangiomas due to thickening of the bony trabeculae. It is the sagittal and coronal correlate of the polka-dot sign observed on axial imaging. It is caused by replacement of normal cancellous bone by coarse, scler...

Doughnut sign (chest)

The doughnut sign can be appreciated on the lateral chest radiograph of patients with mediastinal adenopathy, most commonly seen in pediatric patients with pulmonary tuberculosis infection1. The sign is made up of precarinal, subcarinal and retrocarinal lymph nodes which surround the radiolucen...

Windswept knees

Windswept knees refer to the appearance of a bilateral knee joint deformity where one knee is in valgus and the other is in varus. The name describes the position of the knees if the wind blew across the legs of a patient, causing this evocatively-named appearance. Pathology Etiology Most cau...

V sign (disambiguation)

Signs inspired by the letter V have been described in several different pathologies: inverted V sign (pneumoperitoneum) inverted V sign (spinal cord) Naclerio V sign (pneumomediastinum) V sign (interphalangeal joint subluxation)

Delta sign (disambiguation)

The delta sign has been described in several different pathologies: delta sign (brain) empty delta sign (brain) double delta sign (MSK)

T sign (disambiguation)

The T sign has been described in several different pathologies: T sign (obstetrics) upper T sign (brain) lower T sign (brain)

Target sign (cholangiocarcinoma)

The target sign of cholangiocarcinoma refers to the appearance of intrahepatic mass-forming cholangiocarcinoma on DWI consisting of a centrally hypointense area and peripherally hyperintense rim. The presence of this sign favors cholangiocarcinoma over hepatocellular carcinoma. It is present in ...

Periportal halo sign (MRI)

The periportal halo sign on liver MRI is a specific sign of primary biliary cholangitis (formerly primary biliary cirrhosis) that is characterized by rounded low signal intensity around portal venous branches, 5-10 mm in size, on T1- and T2-weighted images. These lesions are usually numerous, in...

Meniscus sign (cholangiography)

The meniscus sign on cholangiography suggests impacted choledocholithiasis and is characterized by a concave cutoff of the lower common bile duct lumen. When a stone is impacted in the distal duct, fluid may not be visualized on the sides of the stone and therefore the contour of the duct termin...

Pleural pointillism

Pleural pointillism is multiple high signal regions on b=1000 diffusion-weighted imaging but not at lower b-values. It can be a reliable tool allowing differentiation of malignant from benign pleural lesions and can help guide biopsy 1-3. Its sensitivity is reported to be 93-100% and specificit...

Follicular ring sign

The follicular ring sign is considered as a characteristic sonographic sign for early diagnosis of ovarian torsion 1. It is defined as a prominent (1-2 mm thick) hyperechoic margin seen concentrically around the antral follicles of the torsed ovary, which are usually small (3‐7 mm in diameter) a...

Chain of lakes sign

The chain of lakes sign is a radiological finding describing the appearance of the pancreatic ducts in cases of chronic pancreatitis. Due to repeated inflammation, fibrosis occurs and results in damage and atrophy of the pancreatic tissue as well as dilatation and beading of the main pancreatic ...

Pulmonary target sign

The pulmonary target sign has been described in the lung parenchyma as a central high attenuation focus surrounded by one or more dense complete or incomplete ring-like consolidation, forming one or more circles. This sign has been predominantly reported on non-contrast chest CT in patients with...

Chinese dragon sign (vascular)

The Chinese dragon sign is a radiological sign on abdominal radiograph and CT describing the radiologic appearance of calcified tortuous splenic artery that resembles a Chinese dragon. The tortuous splenic artery segment on the splenic hilum side represents the dragon head while the other arteri...

Mistletoe sign

The mistletoe sign refers to solid enhancing perivascular masses around the coronary arteries in the presence of idiopathic retroperitoneal fibrosis (Ormond's disease). The presence of the mistletoe sign on cardiac MRI and coronary CT angiography is relatively rare, but it might be a characteri...

Peritoneal to abdominal height ratio (PAR)

Peritoneal to abdominal height ratio (PAR) ≥0.52 is a statistically associated sign for raised intra-abdominal pressure >12 mmHg in the context of abdominal compartment syndrome in critically ill patients in CT. It can be calculated by dividing the distance from the linea alba to the posterio...

Absent posterior limb sign

The absent posterior limb sign is one of the main MRI findings of prognostic significance in term neonates with suspected hypoxic-ischemic brain injury. An absent posterior limb sign is defined as loss of the normally distinct hyperintensity on T1-weighted images in the posterior part of the pos...

Split scar sign (rectal cancer response assessment)

The split scar sign has been described as a feature on rectal cancer MRI studies acquired following chemoradiotherapy and having a high specificity and positive predictive value for a complete response 1. It is identified on high resolution T2 weighted imaging and refers to the presence of low ...

Black line sign

The black line sign refers to a hypointense linear area in the articular cartilage on magnetic resonance imaging, first described in the trochlear groove 1-3. These lesions have been found also in all other regions of articular cartilage in the knee and not only on T2 weighted images but also i...

Depth-of-fissure sign

The depth-of-fissure sign, also known as apex-of-fissure sign or bottom-of-fissure sign, is a radiographic sign that helps to recognize cerebellar infarcts in children as well as in adults 1-3. Usage The 'depth-of-fissure' sign is recognized on cross-sectional imaging studies of the brain, es...

Grey Turner sign

The Grey Turner sign refers to the clinical finding of atraumatic flank ecchymosis, which is occasionally associated with retroperitoneal hemorrhage, classically due to hemorrhagic pancreatitis 2. It is thought to occur when blood extravasates from the posterior pararenal space and crosses throu...

Tumor deposits

Tumor deposits (in the context of rectal cancer) are discrete nodules of tumor tissue within the mesorectum, often found along the path of draining vessels, and are distinct from lymph node metastases. They are found in >50% of MRI studies of patients with rectal cancer 1. Radiographic features...

Bunch of grapes sign (bronchiectasis)

The bunch of grapes sign, a.k.a. cluster of grapes sign, is a characteristic imaging finding on CT seen in bronchiectasis. Closely apposed dilated bronchi may look like multiple adjacent thin walled cysts which mimic the appearance of a bunch of grapes.

Veil of obscuration sign (shoulder)

Veil of obscuration sign is a sign of posterior shoulder dislocation. It is generally seen on AP radiographs depicting a comminuted fracture of lesser tuberosity that projects over the glenohumeral joint giving rise to a "cloud-like" density or "veil of bone" density, which hides a posterior sho...

Bowl of grapes sign

The bowl of grapes sign has been described in synovial sarcoma. It refers to the characteristic multilobulated lesion subdivided by multiple septa, forming large cystic foci with regions of hemorrhage.

Claw sign (disambiguation)

A claw sign has been named in multiple contexts: claw sign indicating the organ of origin of a mass claw sign of degenerative spondylosis lobster claw sign of renal papillary necrosis

Claustrum sign

The claustrum sign refers to the bilateral claustral involvement seen in febrile infection-related epilepsy syndrome (FIRES). This sign is described on T2 and FLAIR sequences, seen as hyperintensity of both claustra during the acute phase and posterior hypointensity during the chronic phase if ...

Centrilobular micronodules

Centrilobular micronodules are an image descriptor that refers to centrilobular nodules when the nodules are very small and present in a centrilobular distribution in the lungs. They are usually seen with bronchiolitis and can blend into tree-in-bud opacities. Radiographic features CT Postpr...

Waist sign hydrosalpinx

The waist sign arises from the folding of a distended tube upon itself producing indentations on diametrically opposite sides. The waist sign is specific for hydrosalpinx and virtually pathognomonic when seen in association with a tubular-shaped cystic mass. See also cogwheel sign beads on a ...

Fovea alta

Fovea alta is a radiographic sign that refers to an abnormally superior position of the fovea capitis femoris in relation to the acetabular socket. Usage Fovea alta is significantly associated with acetabular dysplasia and can be used as an indicator or diagnostic marker for the condition 1-3,...

Chicken intestine appearance

The chicken intestine is a term used to describe the appearance of a hypersegmented barium column. This appearance is characteristic of intestinal tuberculosis 1. Other radiographic findings such as accelerated intestinal transit, flocculation and dilution of the barium and, luminal stenosis wi...

Phantom organ sign

The phantom organ sign is a term used when a large mass arises from a small organ and as a consequence, it is impossible to detect the affected organ. The identification of this sign and other radiological signs such as the embedded organ sign, beak sign, and prominent feeding artery sign on CT...

Embedded organ sign

The embedded organ sign is used to help localize a mass and define the organ from which it originates. When a mass extrinsically compresses an adjacent organ (such as inferior cava vein and gastrointestinal tract) it gives the organ a crescent shape, which is called a negative embedded organ si...

Snoopy sign

The Snoopy sign is a chest radiographic appearance in pericardial agenesis. It is due to combination of cardiac levoposition (heart shifted to the left), lengthening and flattening of the border of the left ventricle, radiolucency separating the left ventricle and left hemidiaphragm, radiolucenc...

Billowing phenomenon

Billowing phenomenon refers to the presence of contrast medium on contrast-enhanced CT outside of graft metal struts, due to the specific construction characteristic typical of the AFX® stent-graft (Endologix, Inc., USA), designed to treat abdominal aortic aneurysms. It has a unique internal sca...

Ring shadow (chest)

Ring shadows on chest x-ray are classically associated with cystic bronchiectasis 1,2 but the term has also been used to describe a normal bronchus imaged end-on 3.

Staghorn pattern of vascularity

The staghorn pattern of vascularity is a pathological term describing a pattern of vascularity seen on low-power light microscopy. It is defined by multiple thin-walled, sharply-branched and jagged vessels having an "antler-like" or "staghorn-like" appearance 1. It is classically described with...

Ischial spine sign

The ischial spine sign is a radiographic sign on the AP view of the pelvis, for the diagnosis of acetabular retroversion, which poses a form of pincer morphology and predisposes to femoroacetabular impingement. Acetabular retroversion seems to be a result of a rotation of the entire acetabular ...

Hypoattenuated leaflet thickening

Hypoattenuated leaflet thickening (HALT) is an imaging feature seen on cardiac CT in the setting of subclinical leaflet thrombosis of prosthetic heart valves. In the setting of surgical or transcatheter aortic valve replacement (TAVR), the evaluation for hypoattenuated leaflet thickening should...

T-sign (elbow MRI)

The T-sign is seen on a coronal T2 or fat-saturated intermediate-weighted MRI of the elbow. It refers to the interposition of joint fluid between the ulnar insertion of the ulnar collateral ligament and the sublime tubercle and indicates a partial undersurface tear of the distal anterior bundle ...

Soap bubble appearance (differential diagnosis)

Soap bubble appearance describes a multi-loculated bubbly appearance of lesion or structure. A soap bubble appearance of a bone lesion refers to: an expansile lytic lesion with internal trabeculations and preserved cortex, usually of benign nature but may be used to describe more aggressive ...

Patellotrochlear index

Patellotrochlear index is one of the methods to determine patellar height. Measurement Patellotrochlear index is measured on a sagittal MR image with the maximal patellar cartilage thickness and the maximal craniocaudal diameter of the patella. Two measurements are made: A: the length of th...

FABER test

The FABER (Flexion, ABduction and External Rotation) test and also sometimes called the Patrick test) is a diagnostic test for pathology of the hip joint or sacroiliac joint. It is done by having the leg flexed and thigh abducted and externally rotated with the patient lying supine. The knee a...

Pelvic brim sign

The pelvic brim sign is seen in the AP view of the pelvis and refers to a thickening of the pelvic brim outlined by the iliopectineal line. It is due to an osteoblastic reaction seen and first described in Paget disease, which leads to cortical thickening and sclerosis 1.

Iliopectineal line

The iliopectineal line is seen in the AP view of the pelvis and serves to evaluate the anterior acetabular column 1,2. Measurement The iliopectineal line is a curvilinear line running from the sacroiliac joint along the medial border of the iliac wing and the superior border of the superior pu...

Ilioischial line

The ilioischial line, also known as the Köhler line, is a radiologic feature seen in the AP pelvis view and serves to assess the posterior acetabular column 1-4. Measurement The ilioischial line takes its course along the lateral border of the obturator foramen to the medial border of the ilia...

Leborgne's law

Leborgne's law in mammography represents a classic clinical observation where the clinical (palpable) size of a malignant breast mass commonly exceeds the radiographic one 1. The peritumoral edema and/or desmoplastic reaction are thought to be the cause of this phenomenon. The law has been des...

Ring around artery sign

The ring around artery sign refers to a (semi-) circular radiolucency surrounding the right pulmonary artery caused by mediastinal air in the case of pneumomediastinum 1-3. The sign was originally described on lateral chest radiographs 1-4 but can be equally appreciated on sagittal multiplanar ...

Empty vertebral body sign

The empty vertebral body sign is referred to as a radiolucency on a vertebral body seen on the AP radiograph in patients with a flexion-distraction injury mechanism 1-3 caused by the absent superposition of the posterior spinal elements onto the vertebral body. In other words, the sign results ...

Double anterior cruciate ligament sign

The double anterior cruciate ligament (ACL) sign describes a curvilinear, low signal intensity bandlike structure paralleling the anterior cruciate ligament 1-3 and is of rare occurrence 1. It can be seen in bucket-handle meniscal tears from either the medial or lateral meniscus 1-3. Dependin...

Persistent nephrogram

Persistent nephrograms occur when intravenous contrast media is retained by both kidneys for more than 3 minutes. Terminology Persistent nephrograms are characteristically bilateral and are usually distinguished from delayed nephrograms, which occur unilaterally. Pathology Etiology systemi...

Anomalous insertion of the medial meniscus

Anomalous insertion of the medial meniscus (AIMM) is an anatomical variation of the insertion of the anterior root of the medial meniscus. Terminology Defined as a congenital variation in the insertion of the anterior root of the medial meniscus onto the anterior cruciate ligament (ACL). The...

Cliff sign (hip microinstability)

The cliff sign in hip microinstability is a steep drop-off and loss of normal sphericity of the lateral femoral head. Radiographic features Plain radiograph Shenton line distortion subluxation of the femoral head sclerosis of the femoral neck MRI <3 mm anterior lateral capsule >5 mm ante...

Popeye sign

Popeye sign is a pronounced bulging muscle in the distal aspect of the biceps region of the arm. It is clinically apparent with a complete long head of biceps tendon tear which causes distal migration of the long head of biceps muscle. History and etymology Defined by the distal migration of...

Hellmer sign

Hellmer sign is a radiographic finding depicting medial displacement of the lateral edge of the liver from the peritoneal wall. It was originally described as a pathognomonic sign of ascites. However, this displacement can also be caused by intraperitoneal fat, extraperitoneal free fluid or a ma...

Ice cream cone sign (disambiguation)

The ice cream cone sign may refer to: ice cream cone sign (middle ear ossicles) ice cream cone sign (vestibular schwannoma)

Sandwich sign (disambiguation)

The sandwich sign is used for two different imaging appearances: sandwich sign (Marchiafava-Bignami disease) sandwich sign (mesentery) Sandwich sign has also been coined for the appearance of: primary pleural lymphoma 1,2 mediastinal lymphoma 3 marrow edema and hemorrhage on MRI of flexion...

Keyhole sign (disambiguation)

The keyhole sign may refer to: keyhole sign (intracapsular breast implant rupture) 1 keyhole sign (posterior urethral valves) 2 keyhole sign (neural exit foramina)

Mosaic appearance (disambiguation)

The evocative appearance of a mosaic is used for two different entities: mosaic attenuation of the lungs mosaic pattern of Paget disease of the bone

Doughnut sign (orbit)

The doughnut sign of optic nerve sheath meningioma refers to the appearance of this tumor on coronal CT/MRI. The meningioma forms a thick cuff of enhancing tumor around the central non-enhancing optic nerve, mimicking the appearance of a ring doughnut. It is the coronal equivalent of the tram-tr...

Sail sign (larynx)

The sail sign of the larynx refers to the axial appearance of unilateral dilatation of the laryngeal ventricle due to vocal cord/fold paralysis. It should not be confused with the several other sail signs in radiology. Radiographic features CT Axial images at the level of the glottis show the...

Scallop sign

The scallop sign is a radiological sign initially described in rheumatoid arthritis of the wrist. It refers to the appearance of the ulnar aspect of the distal radius on a plain radiograph of the wrist, where it has a scalloped shape with a sclerotic border 1,2. It occurs due to progressive ero...

Alphabet inspired signs

There are many alphabet-inspired signs in radiology: A line (US artifact) C sign (MSK) delta sign delta sign (brain) double delta sign (MSK) empty delta sign (brain) D sign (cardiac) E sign gamma sign (bicornuate uterus) G sign (gout) H-shaped vertebrae H sign J-shaped sella J sign...

Food inspired signs

There are many food-inspired signs in radiology: Cheerio sign (disambiguation) Cheerio sign (pulmonary nodule) Cheerio sign (shoulder) double Oreo cookie (glenoid labrum) hamburger sign (spine) head cheese sign (lungs) honeycombing (lungs) licked candy stick appearance (bones) linguine ...

Adrenal congestion

Adrenal congestion is considered to possibly precede non-traumatic adrenal hemorrhage 1, and refers to adrenal gland thickening and peri-adrenal fat stranding on imaging, which are nonspecific findings. However, more research is needed to elucidate this entity. A possible explanation for adrena...

Hildreth sign

Hildreth sign describes pain relief with application of a proximal tourniquet in patients with a glomus tumor 1. The rationale is that ischemia will decrease the size of the tumor, as these tumors are highly vascular. The sign is reportedly very sensitive and specific for glomus tumors, with a s...

Meniscus sign (myelography)

The meniscus sign refers to the intradural filling defect which is outlined by the sharp meniscus of intrathecal contrast due to blockage of subarachnoid space by an intradural lesion. The CSF above the blocked segment remains unopacified.

Milky Way (disambiguation)

The Milky Way (disambiguation) has been used for two different radiological appearances: Milky Way appearance on mammography Milky Way sign in peripheral multifocal leukoencephalopathy

Napkin ring sign (disambiguation)

The napkin ring sign may refer to either of the following imaging findings: napkin ring sign (colon): colonic stenosis such as due to colon cancer napkin ring sign (coronary): coronary artery vulnerable plaque A clinical napkin ring sign of myotonia (e.g. in myotonic dystrophy) also exists, w...

Interpeduncular angle

The interpeduncular angle is defined as the angle formed by the posterior half of the cerebral peduncles on axial images. The interpeduncular angle has been proposed as a sensitive and specific measure of intracranial hypotension (reduced) and progressive supranuclear palsy (PSP) (increased)1,2....

Tail sign

The tail sign has been described as being specific to Dandy-Walker malformation in fetal MRI.1 It is described as a linear T2 hypointensity in the inferior part of the vermis. Histologically, it corresponds to a thickness of the fourth ventricle roof that appears raised and dysplastic.1 The sp...

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