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Question

Difficulty: EasyInterpreting Imaging Results

Match the following classic radiographic signs with their corresponding underlying pathognomonic diagnosis.

  • "Steeple sign" on an anteroposterior (AP) neck radiographCroup (Laryngotracheobronchitis)
  • "Thumbprint sign" on a lateral neck radiographAcute epiglottitis
  • "Deep sulcus sign" on a supine chest radiographPneumothorax
  • "Water bottle sign" on an AP chest radiographPericardial effusion

Answer

The steeple sign matches Croup, the thumbprint sign matches Acute epiglottitis, the deep sulcus sign matches Pneumothorax, and the water bottle sign matches Pericardial effusion.
Each classic radiographic sign corresponds to a specific anatomical alteration caused by its underlying pathology: subglottic narrowing in croup, epiglottic swelling in epiglottitis, anterobasal pleural air collection in a supine patient with pneumothorax, and symmetric pericardial fluid accumulation in a pericardial effusion.

Step-by-Step Solution

1
Identify the etiology of the "steeple sign".
Matches with Croup.
Viral inflammation causes subglottic narrowing, which produces a tapering appearance on an AP radiograph.
2
Identify the etiology of the "thumbprint sign".
Matches with Acute epiglottitis.
Bacterial infection leads to a swollen epiglottis that visibly resembles a thumb on lateral neck films.
3
Identify the etiology of the "deep sulcus sign".
Matches with Pneumothorax.
In a supine patient, pleural air collects anterobasally, which abnormally deepens the costophrenic angle on an X-ray.
4
Identify the etiology of the "water bottle sign".
Matches with Pericardial effusion.
Fluid accumulation in the pericardial sac globally and symmetrically enlarges the cardiac silhouette.

Key Concept

Classic eponymous radiographic signs are high-yield diagnostic clues for rapidly identifying acute airway and cardiopulmonary conditions.
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Interpreting Imaging Results

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