Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

44 results found
Article

Retroaortic anomalous coronary sign (echocardiography)

The retroaortic anomalous coronary (RAC) sign describes the sonographic appearance of an anomalous left coronary artery traveling posteriorly to the aortic root. It is most commonly observed with anomalous origin of the left circumflex artery from the right sinus of Valsalva, but is also describ...
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Contrast level within inferior vena cava

A dependent contrast level within the inferior vena cava is a situation that can be observed in some cases with inferior vena caval contrast reflux. Its presence is usually associated with very poor cardiac output and can be accompanied by dependent layering of venous refluxed contrast within th...
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Inferior vena caval contrast reflux

Reflux of contrast into inferior vena cava can be common findings seen on CT. It is considered a specific but insensitive sign of right-sided heart disease / right heart dysfunction at low contrast injection rates although the usefulness decreases with high injection rates. Conditions associate...
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Apical rocking

Apical rocking is a radiographic sign that might be seen either on echocardiography or cine imaging on cardiac MRI in the four-chamber view and refers to a movement of the cardiac apex in cardiac dyssynchrony. It is characterized by the following 1-3: short-timed movement of the apex towards th...
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Rosenbach sign (disambiguation)

Rosenbach sign may refer to several different clinical signs: Rosenbach sign (AV regurgitation) Rosenbach sign (eye) Rosenbach sign (hemiplegia) History and etymology Ottomar Ernst Felix Rosenbach (1851-1907), a German physician born in Prussian County in Silesia, graduated from medicine in...
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Rosenbach sign (aortic valve regurgitation)

Rosenbach sign is a clinical sign that is seen in severe aortic/tricuspid valve regurgitation. It is elicited as pulsation of the liver, during systole, and it is primarily due to the increased cardiac output and associated retrograde blood flow into the liver 1-3. See also Rosenbach also gave...
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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...
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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...
Article

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...
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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...
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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...
Article

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 napkin ring is a decorative household item used in some Western societies to hold...
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Chen sign

Chen sign on chest radiography is the prominence of the left basal pulmonary vasculature, compared to the right, seen in valvular pulmonary stenosis. It is due to the asymmetric increase in pulmonary blood flow to the left lung due to preferential blood flow into the left pulmonary artery after ...
Article

Fallen contrast sign

The fallen contrast sign refers to a trace of concentrated contrast material layering along the dependent left atrial wall during contrast-enhanced cardiac CT, suggestive of a right-to-left shunt. The finding has primarily been described as an indirect sign in sinus venosus atrial septal defect ...
Article

Pyrexia

Pyrexia (or fever) is a clinical sign, indicated by an abnormally elevated core body temperature, which is defined by several medical societies as ≥38.3°C (≥≈101°F). The temperature elevation may be persistent or episodic. If the body temperature is greater than 41.5°C - a rare phenomenon - it i...
Article

De Winter pattern (electrocardiogram)

An electrocardiographic finding suggestive of impending myocardial infarction, the de Winter's pattern (or "de Winter's T-waves") describes an abnormality thought to be indicative of acute occlusion of the proximal left anterior descending coronary artery (LAD) 2. Timely recognition of this patt...
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60/60 sign (echocardiography)

The 60/60 sign in echocardiography refers to the coexistence of a truncated right ventricular outflow tract acceleration time (AT <60 ms) with a pulmonary arterial systolic pressure (PASP) of less than 60 mmHg (but more than 30 mmHg). In the presence of right ventricular failure, it is consisten...
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Septal flash

Septal flash, also known as septal beaking, is a sign of interventricular dyssynchrony seen on echocardiography or cinematographic cardiac CT/MRI. It represents an abnormal rapid movement pattern of the interventricular septum during pre-ejection systole (i.e. isovolumic contraction): septal mo...
Article

McConnell's sign (echocardiography)

The McConnell's sign describes a regional pattern of acute right ventricular dysfunction on transthoracic echocardiography first observed in a cohort of patients with acute pulmonary thromboembolism. In contrast to the global wall motion abnormalities observed in chronic right ventricular dysfun...
Article

Straight left heart border sign

Straight left heart border sign is a recently described finding on chest radiograph. It is a fairly specific (84%) sign of hemopericardium after a penetrating chest trauma, although sensitivity at 40% is relatively poor. Positive predictive value (PPV) was found to be 89% 1. It is different to ...
Article

Ventricular interdependence

Ventricular interdependence (or ventricular coupling) is a phenomenon whereby the function of one ventricle is altered by changes in the filling of the other ventricle. This leads to increase in volume of one ventricle associated with a decreased volume in the opposite ventricle 1. This conditi...
Article

Cockade sign (disambiguation)

There are several described cockade signs in radiology: cockade sign (aorto-left ventricular tunnel) 1 cockade sign (appendicitis) 2 cockade sign (GI tumors) 4 cockade sign (hypertrophic pyloric stenosis) 3 cockade sign (intraosseous lipoma) History and etymology It is named after a cocka...
Article

Third mogul sign

The third mogul sign can be seen on frontal chest radiograph in the presence of left atrial enlargement. It refers to an extra mogul or bump along the upper left cardiac silhouette just below the left main bronchus. The third mogul sign commonly represents the enlarged left atrial appendage, pa...
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Moguls of the heart

The 'moguls of the heart' refer to the bulges of the cardiomediastinal contour on frontal chest radiographs. The cardiomediastinal bulges are likened to skiing moguls (bumps of packed snow on a mountainside sculptured by turning skis). Awareness of their usual locations and etiologies is helpful...
Article

Box-shaped heart

A box-shaped heart is a radiographic description given to the cardiac silhouette in some cases of Ebstein anomaly. The classic appearance of this finding is caused by the combination of the following features: huge right atrium that may fill the entire right hemithorax shelved appearance of th...
Article

Earth-heart sign

The earth-heart sign is a sign of cardiac compromise that may be seen on chest radiographs of patients with tension pneumomediastinum. The substantial pressure exerted on the heart by the gas trapped in the mediastinum with subsequent impairment of central venous return and obstruction of diast...
Article

Ace-of-spades sign (heart)

Ace-of-spades sign refers to the pathognomonic configuration of the left ventricle as seen in apical hypertrophic cardiomyopathy 1-3. It consists of marked ventricular wall thickening at the apex resulting in cavity narrowing at the apex with a relatively normal appearance of the mid-ventricula...
Article

Transient ischemic dilatation

Transient ischemic dilatation (TID) is a paradoxical phenomenon seen in myocardial perfusion SPECT imaging.   With severe balanced coronary artery disease, myocardial ischemia may result in apparent enlargement of the left ventricular cavity during stress. The cause of this is not entirely clea...
Article

Septal bounce

Septal bounce is a sign of ventricular interdependence on echocardiography, cardiac CT, and cardiac MRI, manifested by paradoxical interventricular septal movement during early diastole (i.e. initial septal movement towards and then away from the left ventricle) seen mainly in constrictive peric...
Article

Porcelain left atrium

Porcelain left atrium, also known as coconut left atrium, is a term used when a large part of or the entire left atrial wall becomes calcified. It can occur as a rare consequence of endocarditis (with underlying rheumatic heart disease). It has also been described in the setting of end-stage ren...
Article

Figure of eight appearance

The following lesions may resemble a figure of eight (sometimes referred to as snowman shaped): supracardiac variety of total anomalous pulmonary venous return 1 pituitary macroadenoma with suprasellar extension 2 intraspinal neurofibroma with extraspinal extension through neural foramina di...
Article

Panzerherz (heart)

Panzerherz (or armoured heart) is a term used to describe the appearance of the heart in calcified constrictive pericarditis. The pericardium becomes circumferentially thickened with calcification, limiting the ability of the heart to contract. The rim of dense calcification describes how the h...
Article

Napkin-ring sign (heart)

The napkin-ring sign is a feature of high-risk coronary artery atherosclerotic plaque on CT coronary angiogram (coronary CTA). It has been shown to possess a high predictive value in predicting future cardiac events and is considered one of the imaging correlates of an unstable plaque.  It is n...
Article

Egg-on-a-string sign (heart)

Egg-on-a-string sign, also referred to as egg on its side, refers to the cardiomediastinal silhouette seen in transposition of the great arteries (TGA). The heart appears globular due to an abnormal convexity of the right atrial border and left atrial enlargement and therefore appears like an ...
Article

Snowman sign (total anomalous pulmonary venous return)

Snowman sign refers to the configuration of the heart and the superior mediastinal borders resembling a snowman. This is seen in total anomalous pulmonary venous return (TAPVR) type I (supracardiac type). It is also referred to as the figure of 8 sign. It is an abnormality of the fetal circulat...
Article

Shmoo sign

Shmoo sign refers to the appearance of a prominent, rounded left ventricle and dilated aorta on a plain PA chest radiograph giving the appearance of Shmoo, a fictional cartoon character in the comic strip Li'l Abner, which first appeared in 1948 5. This sign is indicative of left ventricular enl...
Article

Finger clubbing

Finger clubbing, also called "drumstick fingers" or Hippocratic fingers, is a common clinical sign mainly seen in patients with heart or lung disease. The term is used to describe an enlargement of the distal phalanges of the fingers, giving them a drumstick or club-like appearance.  Clinical p...
Article

Double density sign (left atrium)

The double-density sign, also known as the double right heart border, is seen on frontal chest radiographs in the presence of left atrial enlargement, and occurs when the right side of the left atrium extends behind the right cardiac shadow, indenting the adjacent lung and forming its own distin...
Article

Walking man sign (chest x-ray)

The walking man sign is seen on a lateral chest radiograph and is a sign of left atrial enlargement. It results from posterior displacement of the left main bronchus such that it no longer overlaps the right bronchus. The left and right bronchus thus appear as an inverted 'V', mimicking the legs...
Article

Atrial escape

Atrial escape refers to a chest x-ray sign of massive left atrial enlargement and is an exaggerated version of the double density sign.   Normally, the right border of the left atrium is not visible. As it enlarges it forms a distinct border projecting through the right heart shadow, medial to ...
Article

Naclerio V sign

The Naclerio V sign is a sign described on the plain film in patients with a pneumomediastinum occurring often secondary to an esophageal rupture.  It is seen as a V-shaped air collection. One limb of the V is produced by mediastinal gas outlining the left lower lateral mediastinal border. The ...
Article

Upper lobe pulmonary venous diversion

Upper lobe pulmonary venous diversion (also described as cephalisation of the pulmonary veins) reflects elevation of left atrial pressure and is an early sign of pulmonary edema. Clinical presentation The normal left atrial pressure is 5-10 mmHg. An elevation of left atrial pressure to 10-15 m...
Article

Double density sign (osteoid osteoma)

The double density sign, also sometimes clumsily referred to as the hotter spot within hot area sign, is a bone scan sign of an osteoid osteoma. It refers to a central focus of intense uptake (the nidus) within a surrounding lower, but nonetheless increased uptake, rim. See also double densit...
Article

Saddle pulmonary embolism

Saddle pulmonary embolism commonly refers to a large pulmonary embolism that straddles the bifurcation of the pulmonary trunk, extending into the left and right pulmonary arteries. If large enough, it can completely obstruct both left and right pulmonary arteries resulting in right heart failur...

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