PDF Compilation of Important Radiological Signs

[RADIOLOGICAL SIGNS]

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Below is the exhaustive list of Collection of Important Radiological Signs . To get the maximum benefit we advise you to download the PDF version and learn it. Also as you move forward you can add additional items as you keep finding them (Thus ensuring that the PDF is updated.) The PDF Version is well formatted version for taking print outs.

Ø  Radiological Signs
S. No. Remarks
1. Accordion sign on CT –        pseudomembranous enterocolitis
2. Angel wing sign or spinnakersign –        pneumomediastinum
3. Angiographic string sign or carotid string sign –        Internal Carotid artery dissection
4. Antral nipple sign –        pyloric stenosis
5. Antral pad sign –        pancreatic cancer/pancreatitis
6. Apple core sign –        colorectal carcinoma
7. Apple core sign –        synovial chomdromatosis of femur
8. Arcuate sign –        cruciate ligament injury of knee
9. Arrowhead sign –        acute appendicitis
10. Banana sign –        chiari 3 malformation
11. Bare orbit sign –        neurofibromatosis 1
12. Bat wing 4th ventricle –        absent verrnis and apposed cerebellar hemispheres
13. Bat wing pulmonary opacities –        cardiogenic pulmonary edema
14. Beak sign –        hypertrophic pyloric stenosis/arterial dissection
15. Bird beak sign –        achalasia
16. Bears paw sign –        xanthogranulomatous pyelonephritis
17. Boomerang sign(MRI) –        splenium of corpus callosurn/diffuse axonal injury/multiple sclerosis
18. Bracket sign –        peri-callosal lipoma of brain
19. Butterfly glioma –        high grade astrocytoma crossing midline
20. Butterfly vertebra –        anterior spina bifida/alagille syndrome
21. Ceacal bar sign –        acute appendicitis
22. Celery stalk sign –        Mucoid degeneration of anterior cruciate ligament
23. Cleft sign(MRI) –        meningioma
24. Cluster of grapes –        hydatiform mole
25. Comb sign –        hypervascular mesentry in Crohns disease
26. CT Comma sign –        concomitant EDH+SDH
27. Cumbo sign(Onion peel sign) –        pulmonary hydatid cyst
28. Deep sulcus sign –        pneumothorax
29. Dense rim sign –        high attenuation crescent sign

–        Abdominal aortic aneurysm

30. Double duct sign –        pen ampullary carcinoma
31. Double line sign(MRI) –        osteonecrosis
32. Double rim sign –        brain abscess
33. Double track sign –        pyloric stenosis
34. Double wall sign(Rigler sign) –        pneumoperitoneum
35. Dural tail sign –        meningioma
36. Empty delta sign(CECT) –        superior sagittal sinus venous thrombosis
37. Finger in glove sign –        allergic bronchopulmonary aspergillosis
38. Floating aorta sign –        retroperitoneal masses
39. Floating head appearance –        ahondrogenesis
40. Galaxy sign –        pulmonary sarcoidosis
41. Garland sign(pawnbrokers sign) –        sarcoidosis
42. Achondroplasia –        Achondroplasia

–        Trident hand

–        Chevron sign

–        Bullet nose vertebra

–        Tomb stone iliac blades

43. Air crescent sign –        Aspergilloma /Pus/Clot/ Hydatid lung
44. Antral sign (Holman miller sign) –        Juvenile nasopharyngeal angio fibroma (on CT)
45. Ankylosing spondylitis –        Bamboo spine/Romano’s sign

–        Squaring/Dagger sign

–        Syndesmophytes

46. Bat wing appearance –        Pulmonary edema
47. Bed ford sign –        Aorta displaced laterally due to enlarged left atrium
48. Blue dot sign/Nubbin sign –        Cyst of morgagni  [D/d of torsion testis]
49. Brodies abscess –        Tunneling
50. Bone within bone –        Osteopetrosis

–        Sickle cell anemia

51. Box shape heart Straight upper cardiac border –        Ebstein Anomaly
52. Bone within bone H-shaped vertebrae –        Sickle cell anemia
53. Bouchard’s/Heberden’s nodes –        Osteo-arthritis
54. Cardiac valve calcification –        Endomyocardial fibrosis
55. Cannon ball appearance –        Metastasis of lung
56. Central dot sign –        Caroli’s disease
57. Crazy pavement appearance –        Alveolar proteinosis
58. Cluster of grapes –        Cystic bronchiectsis
pericardium
59. Cod fish vertebra –        Osteoporosis

–        Osteomalacia

–        Hyperparathyroidism

60. Codman’s triangle, sun ray appearance –        Osteosarcoma
61. Corkscrew esophagus –        Diffuse esophageal spasm
62. Continuous diaphragm –        Air beneath heart – pneumo sign
63. Congenital syphilis –        Saber tibia

–        Moth eaten skull

–        Hot cross bun skull

–        Frontal bossing of parrot

–        Hutchinson teeth, mulberry

–        molars, bull’s dog jaw

–        Saddle nose,

64. Coeur-en-Sabot/ Boot shaped heart

Right aortic arch

–        TOF (Tetralogy of Fallot)
65. Celery stalk appearance –        Congenital rubella
66. Comet tail sign/ Diamond ring sign

Inverted V sign/pearl Necklace GB

–        Adenomyomatosis GB
67. Double aortic knuckle

Double barell aorta

–        Aortic dissection
68. Double ring sign –        Osteoid Osteoma [O-O = double ring]
69. Diamond ring sign, Comet tail sign

Inverted V sign, pearl

necklace GB

–        Adenomyomatosis gall bladder
[Rokitansky – Aschoff Sinuses]
70. Egg in cup appearance/ Square root sign –        Constrictive pericarditis
71. Egg on side appearance –        D-TGA, uncorrected TGA
72. Waterfall appearance, convex Lt. heart border –        L-TGA
73. E-sign, reverse of 3 sign Dock’s sign (Inferior rib notching of 3-8 ribs –        Coarctation of aorta (COA)
74. Egg shell calcification –        Silicosis/Sarcoidosis
75. Erlen Meyer flask de­formity of distal femur –        Osteopetrosis

–        Thalassemia

–        Gaucher’s disease

76. Fallen fragment sign, trap door sign –        Unicameral bone cyst
77. Fish mouth vertebra –        Sickle cell anemia

–        Homocystenuria

78. Flowing calcifications –        Diffuse idiopathic skeletal hyper osteosis (DISH)
79. Flowing candle wax –          Sarcoidosis (ocular)
80. Flower bouquet appearance –        Cystoid macular edema [flower bouquet in CME!]
81. Ground glass appearance –        Infracardiac TAPVC
82. Ground glass appearance, shepherd crook deformity –        Fibrous dysplasia
83. Glossy heart (speckled) on ECHO –        Amyloidosis
84. Ground glass septum –        HOCM
85. Gloved finger appearance –        ABPA
86. Ground glass haze on HRCT –        Alveolitis
87. Goose neck deformity (on LV angio) –        Primum ASD
88. Great Hilar dance (On flouroscopy) –        ASD
89. Golden-S sign –        Bronchogenic carcinoma (central) + Upper lobe collapse
90. Hair on end/Crew-cut/ Hair brush appearance –        Thalassemia sickle cell anemia
91. Hair on end /Crew cut/ Hair brush

Flask shaped femur

Rodent facies

–        Thalassemia
92. Halo appearance on CT –        Invasive aspergillosis
93. Higaumenaki’s sign –        Unilateral enlargement of sternal end of clavicle due to periostitis
94. Jug handle appearance –        Primary pulmonary hyperten­sion
95. Left atrial enlargement –        1st sign – Elevation of Lt. main bronchus

–        2nd – Widening of carina

–        3rd  Double cardiac shadow

96. Licked candy stick appearance –        Leprosy
97. Light bulb appearance –        Posterior dislocation of shoul­der
98. Looser’s zone/ milkman’s pseudofractures –        Osteomalacia
99. Looser’s zones –        Osteomalacia
100. Linear calcification of ascending aorta –        Syphilitic aortitis
101. Maladie-de-Roger defect –        Small VSD
102. Mercedes Benz sign/ Inverted sea gull sign –        Ca+2 deposition in gall bladder
103. Metacarpal sign –        Hyper parathyroidism,Turner’s syndrome
104. Metaphyseal translucencies –        Leukemia
105. Melting snow appearance –        Mycetoma
106. Molten candle wax appearance –        Leri’s disease (Melorheostosis)
107. Money bag/water battle/ leather bottle/ flask shaped heart –        Pericardial effusion
108. Osteophytes –        Osteoarthritis
109. Onion peel appearance –        Ewing’s sarcoma
110. “O”ring sign/Popcorn calcification/Annular calcification –        Chondromas
111. Perthe’s disease –        Waldenstorm sign Lat­eral displaced femoral head [Catterall classification]
112. Pepper pot skull/Salt & pepper skull –        Hyperparathyroiclism
113. Picture frame vertebra

Cotton wool skull

–        Paget’s disease
114. Popcorn calcification in –        Calcified aortic valve
115. Polka dot on CT –        Hemangioma center of heart
116. Psoriatic arthritis –        Cup & pencil appearance

–        Sausage digit

–        Opera glass

117. Popcorn calcification –        Hamartoma of lung
118. Pipe stem ureter –        TB ( Golf hole ureter, thimble bladder) Also in retroperito­neal fibrosis
119. Pipestem cirrhosis –        Schistosomiasis
120. Palla Sign –        PA ( P ulinonary A rtery) Rt side – enlarges
121. Pulmonary

Embolism

–        Westermark sign

–        Oligemia

122. Melting sign –        Rapid melting infarct
123. Fleishner sign –        Elevated hemidiaphragm
124. Hampton hump –        Wedge opacity
125. Mc. Connel’s sign

Rat tail/Bird beak appearance

–        Achalasia cardia
126. Rain drop appearance on skull

Multiple punched out lesions

–        Multiple myeloma
127. Rocker bottom feet –        Edward’s syndrome
128. Rugger Jersey spine –        Osteo petrosis

–        Renal osteo dystrophy

129. Signet ring –        Bronchiectasis
130. String of beads –        Varicold bronchiectasis
131. Swirl sign –        EDH [extra dural heamorrhage]
132. Syndesmophytes –        Ankylosing spondylitis
133. Saw toothed appearance –        Diverticulosis colon [on barium enema]
134. Saw toothed ECG –        Atrial flutter
135. Saw toothed epidermis –        Lichen planus
136. Shepherd crook deformity –        Fibrous dysplasia of Neck of femur
137. Spinnaker sail sign –        Sail shaped thymus + air

–        .Pneumopericardium

138. Spider web appearance –        Kerley ‘c’ lines
139. Spider Nevi –        Liver failure
140. Spider leg deformity –        Polycystic kidney disease
141. Silhoutte sign –        Intrathoracic radiopaque mass, causing loss of silhouette
142. Spring water cyst –        Pericardial cyst
143. Strawberry gall bladder –        Cholesterosis
144. Scimitar sign/Turkish sword appearance –        Partial APVC > TAPVC (Congenital venolobar syn)
145. Schimitar sacrum –        Anterior meningocele
146. Sitting duck heart –        Persistent truncus arteriosus
147. Snowman sign/Figure of 8 sign/ Cottage loaf sign –        Supracardiac TAPVC
148. Swiss cheese appearance –        Endometrial hyperplasia (sim­ple)
149. Soap bubble appearance –        Osteo clastoma
150. Sprengel shoulder –        Klippel Feil syndrome
151. Spoon shaped vertebrae –        Pykno dysostosis
152. Spondylolisthesis –        Inverted Napolean hat sign

–        Beheaded Scottish terrier sign

153. Stag antler sign, –        CHF
154. Swan neck deformity

Boutenniere deformity

Hammer toe

 

–        Rheumatoid arthritis
155. Hands-up sign,

Inverted moustache sign

156. Hurler’s Syndrome (MPS-1) –        Antero-inferior beating of vertebra

–        J-shaped sella

–        Simian pelvis

157. Thymus –        Sail sign

–        Wave sign of Muvley

–        Notch sign

158. Transient tachypnea of newborn –        Chest X-ray

–        Prominent horizontal fissure

159. Tram tracking –        Cylindrical bronchiectasis
160. Trees in bud appearance –        Endo bronchial spread of TB
161. Telephone handle bones Clover leaf skull –        Thanatophoric dwarf
162. Terry Thomas sign –        Scapho lunate dislocation
163. Tiger eye appearance –        Hallervorden – Spatz disease
164. Tubular heart –        Emphysema
165. Tulip bulb aorta –        Marfan’s syndrome
166. Vanishing bile duct –        Primary sclerosing cholangitis

–        (PSC) Primary Biliary Cirro­sis) (PBC)

–        Graft versus Host disease

–        Sarcoidosis

–        Chlorpromazine

167. Vanishing ureter –        Renal transplant
168. Vanishing tumour –        Loculated interlobar fissure in CCF
169. Vertical striations/ Cordruoy cloth/ Paint brush appearance –        Hemangioma
170. Water lily sign –        Camalote sign

–        Hydatid lung

171. Wimberger’s sign –        Sclerotic rim in epi­physis
172. Frenkel white line –        Dense Ca+2 deposits in metaphysic

–        Scurvy

173. Trumerfield zone

Pelkan spur

–        Lucent zone
174. Whirl sign –        Midgut volvulus (on CT)
Ø Intracranial mass
175. Hyperintense + Post contrast enhancement –        Cavernous hemangioma
176. Iso intense + Post contrast enhancement –        Meningioma
177. Hyperintense + Post contrast intensity –        Astrocytoma
178. Hyperintense + Cystic contrast –        Schwannoma
179. Lag sign/ Drop sign –        Supra / Infra spina his weakness
180. Pipe hose appearance –        Crohn’s disease
181. Garden hose appearance / Pipestem colon –        Ulcerative colitis
182. Signet ring sign –        Diffuse Ca GB
183. Crohn’s disease –        String sign of cantor, bull’s eye con target lesion, cobble stone appearance, hose pipe appear­ance
184. Ulcerative colitis –        Lead pipe appearance / Garden hose appearance/pipe stem colon, pseudopolyps, pin point ulcers, collar button ulcers
185. Acute pancreatitis –        Sentinel loop sign, colon cutoff sign, renal halo sign, ground glass appearance
186. Other non-radiological signs –        Cullen sign, Grey Turner sign, Fox sign
187. Chronic pancreatitis –        String of beads/String of pearls/ Chain of lakes appearance/ Rat tail CBD
188. Ca pancreas –        Double duct sign, scrambled egg appearance, (Inverted 3 sign of Frostberg), Rose thorning of 2nd part of duode­num
189. Intestinal TB –        Pulled up caecum / Inverted umbrella sign / Fleschner sign

–        Goose mouth appearance (obtuse angle of caecum)

–        Napkin ulcers in ileum / Purse string appearance

190. Ischemic colitis –        Thumb printing sign
191. Pneumatosis ilntestinalis –        Soap bubble / Bunch of grapes appearance, scalloped sigmoid
192. Pneumoperitoneum –        Football sign/ Rigler sign/ Cupula sign/Triangle sign/ Inverted V appearance
193. String of beads –        Fibromuscular dysplasia

–        + Chain of lakes (chr. pan­creatitis)

–        Subacute intestinal obstruc­tion

194. String sign of cantor –        Crohn’s disease
195. String sign –        Caecal TB/Crohn’s disease/ Congenital hypertrophic pyloric stenosis
196. Hampton’s line –        Benign gastric ulcer
197. Kirklin complex/ carman’s meniscus –        Malignant gastric ulcer
198. Bull’s eye stomach –        Melanoma
199. Trifoliate duodenum –        Chronic scarred duodenal ulcer
200. Moulage sign –        Tube bowel

–        Malabsorption

201. Hellmer’s sign –        Luscent area between liver & lateral abdominal wall

–        Ascites

202. Stacked coin appearance –        Henoch scholein purpura
203. Sawtoothed /serrated appearance –        Colonic diverticula
204. Hirschsprung disease –        AB normal bowel is Constricted proximal to abnormal bowel is dilated
205. Intussusception –        X-ray Target sign/ me­niscus sign, claw sign, coiled spring appearance
206. USG features of Intususception –        Bull’s eye appearance

–        Dough nut sign/ pseudok­idney sign

–        Dance sign (empty RIF)

207. Sigmoid volvulus –        Coffee bean appearance

–        Bent inner tube appearance

–        Bird of prey appearance

–        Liver overlap, left flank over­lap

–        Ace of spade appearance

208. Appendicitis –        Rovsing sign, pointing sign, psoas sign, obturator sign, ar­row head sign, Bostedes sign
209. Ileocaecal valve –        Shark mouth appearance
210. Sun burst calcification/ Central stellate scar –        Fibrolamellar HCC

–        Focal nodular hyperplasia liver

–        Serous cystadenoma of pan­creas

–        Oncocytoma

Ø UROLOGY
211. Bell clapper appearance, blue dot sign –        Torsion testis [Nubbin sign on DMSA]
212. Bunch of grapes appearance –        Multicystic dysplastic kidney
213. Bristles of brush (or) bouquet of flowers appearance –        Medullary sponge kidney
214. Ca-renal pelvis –        Stipple sign/Goblet sign (on RGP) Bergman sign (Stent coiling distal to obstruction, on RGP)
215. Cobra head /adder head/ Spring onion appearance –        Ureterocele
216. Chinese lantern sign –        Epididymal cysts
217. Drooping lily sign –        Ectopic ureter
218. Egg in cup appearance –        Renal papillary rupture
219. Fatty yellow kidney –        Xanthgranulomatous kidney
220. Genito urinary TB –        Kidney – Moth eaten
calyces, bag of PUS-        Ureter – Golf hole ureter,
Pipe stem ureter-        Bladder – Thimble blad‑
der

–        Epididymis – Craggy epididymis, beaded appear­ance, beaded vas deferens

221. Hand joining sign, flow­er vase curve of ureter, Rovsing sign, hand shake sign –        Horse shoe kidney
222. Inverted-J appearance/ Fish hook appearance/ Shepherd crook anomaly –        Retrocaval ureter
223. Rim/cresent sign,

Soap bubble

appearance

–        Hydronephrosis
224. Oncocytoma –        Central stellate scar, spoke wheel appearance

–        Fetal head appearance (Bladder calcification)

–        Parallel calcification (or) tramtrack calcification of urcter

225. Pear sign/Flame sign –        Bladder rupture
226. Pie in sky appearance –        Injury to prostatic urethra
227. Star burst appearance –        Extraperitoneal bladder rupture + all over burst
228. Spider leg deformity/Bell like deformity

Bubble appearance/Swiss cheese appearance/ Sun burst nephrogram

–        Polycystic kidney disease
229. Schistosomiasis On cystoscopy –        Sandy deposits in bladder wall
230. Tear drop bladder –        Extraperitoneal bladder rupture
231. Tobacco bag appearance –        Tubercular salpingitis
232. Yo Yo reflex on RGP –        Incomplete duplication of ureter