Aunt Minnies Radio Signs Flashcards
Caput medusae sign
-Thecaput medusae signis seen in patients with severeportal hypertension. It describes the appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen to join the systemic veins.
Chasing the dragonsign
Chasing the dragonsignis seen intoxic leukoencephalopathycaused by the inhalation of heroin fumes.
Marijuana(cannabisorbong)lung
Marijuana(cannabisorbong)lungrefers to the presence of large apicalbullaein patients who regularly smoke marijuana. A definite causative link between smoking marijuana and bullous lung disease has not been established, and the association may just be coincidental.
Nasal septal perforation
Nasal septal perforationmay affect either the bony, or cartilaginous septum. Most commonly it affects the anterior septal cartilaginous area although withsyphilisit characteristically affects the bony septum.
Claw sign
The claw sign ondiffusion weightedimagingrefers to a pattern of hyperintensity seen in degenerative changes in the spine. The presence of the claw sign makesspondylodiscitisless likely.
Cobblestone appearance
Cobblestoning(having acobblestone appearance)can occur in a number of hollow organs with mucosa, most commonly the bowel, in the setting ofCrohn disease.
Longitudinal and circumferential fissures and ulcers separate islands of mucosa, giving it an appearance reminiscent of cobblestones.
Cobblestone appearance has been reported in:
Crohn disease: small and large bowel
candida esophagitis1
Hirschsprung disease4
eosinophilic gastritis5
duodenitis
Brunner gland hyperplasiaof the duodenum5
nodular lymphoid hyperplasiain duodenal cap
Cobweb sign
Thecobweb signis seen in cases ofarterial dissection(usuallyaortic dissection) on CT angiogram (CTA) examinations and represents strands or ribbons of media crossing the false lumen, and appearing as thin filiform filling defects.
Although it is a specific sign for the false lumen, it is infrequently seen (thus low sensitivity).
Coca-Cola bottle sign
TheCoca-Cola bottle signrefers to the appearance of the muscles of the orbit inthyroid eye disease. The belly of the muscle enlarges with sparing of the tendinous insertion, giving the appearance of the traditional Coca-Cola bottle.
Cockade sign
Thecockade signdescribes the classic appearance of a calcanealintraosseous lipomaseen as a well-defined lytic lesion with a central calcification.
Codman triangle
Codman triangleis a type ofperiosteal reactionseen with aggressive bone lesions. With aggressive lesions, the periosteum does not have time to ossify with shells of new bone (e.g. as seen insingle layerandmultilayeredperiosteal reaction), so only the edge of the raised periosteum will ossify.
The Codman triangle may be seen with aggressive lesions:
osteosarcoma
Ewing sarcoma
osteomyelitis
activeaneurysmal bone cyst
giant cell tumor
metastasis
chondrosarcoma(especiallyjuxtacortical chondrosarcoma)
malignant fibrous histiocytoma
Cogwheel sign
Thecogwheel sign refers to an imaging appearance in pelvic imaging of thickening loops of theFallopian tubeseen on cross-section. There are infolding projections (sometimes looking like nodules) into the Fallopian tube lumen which is likened to that of a cogwheel. The sign is typically described on ultrasound and is indicative oftubal inflammationinpelvic inflammatory diseasewith apyosalpinxor ahydrosalpinx.
Coin lesion
Coin lesionrefers to a round or oval, well-circumscribedsolitary pulmonary lesion.It is usually 1-5 cm in diameter and calcification may or may not be present1,3. Typically but not always the patient is asymptomatic1.
Colon cut-off sign
Colon cut-off signdescribes gaseous distension seen in proximal colon associated with narrowing of the splenic flexure in cases ofacute pancreatitis. Though originally described in abdominal radiographs, this sign has also been demonstrated in contrast enemas and computed tomography1.
Comb sign
Thecomb signrefers to the hypervascular appearance of the mesentery in activeCrohn disease.Fibrofatty proliferation and perivascular inflammatory infiltration outline the distended intestinal arcades. This forms linear densities on the mesenteric side of the affected segments of small bowel, which give the appearance of the teeth of a comb.
Comet tail sign
Thecomet tail signis a finding that can be seen on CT scans of the chest. It consists of a curvilinear opacity that extends from a subpleural “mass” toward the ipsilateral hilum. The comet tail sign is produced by the distortion of vessels and bronchi that lead to an adjacent area ofround atelectasis, which is the mass. The bronchovascular bundles appear to be pulled into the mass and resemble a comet tail.
Comet-tail artifact
Thecomet-tail artifactis agrey-scale ultrasoundfinding seen when small calcific / crystalline / highly reflective objects are interrogated and is believed to be a special form ofreverberation artifact.
Comet tail sign
Comet tail sign(in urological imaging) is helpful in distinguishing aureteric calculusfrom aphlebolithand strongly favours the latter.
The sign refers to a tail of soft tissue extending from a calcification, representing the collapsed/scarred/thrombosed parent vein. When well seen it is said to have a positive predictive value of 100%1.
Color comet-tail artifact
Thecolor comet-tail artifactis an ultrasonographic sign seen in a number of situations when color Doppler scanning is performed.
Typically the artifact, which resembles the grey-scalecomet-tail artifact, is seen in a situation when a small highly reflective (usually calcific) object is interrogated with color Doppler.Twinkling artifactoccurs and immediately deep to the object a tail of linear aliased band of color extends away from the probe.
Coffee-bean sign
Thecoffee-bean sign(also known as thekidney bean signorbent inner tube sign4) is a sign on an abdominal plain radiograph of asigmoid volvulusalthough some authors have also used the term to refer to closed loop small bowel obstructions.Cecal volvulusmay be mistaken with sigmoid volvulus and the number of air-fluid levels help in differentiating the two entities. In cecal volvulus only one air-fluid level is seen compared to sigmoid volvulus with a few air-fluid levels4.
Cobra head sign
Thecobra head sign, also known as thespring onion sign, refers to dilatation of the distal ureter, surrounded by a thin lucent line, which is seen in patients with an adult-typeureterocoele. The cobra head appearance indicates an uncomplicated ureterocele.
The lucent “hood” of the cobra represents the combined thickness of the ureteral wall and prolapsed bladder mucosa, outlined by contrast material within the bladder lumen.
Cloverleaf skull
Cloverleaf skull,also known askleeblattschädel, refers to a type of severecraniosynostosiswhich gives the skull a cloverleaf shape. It is very rare, with less than 130 case reports globally.It typically results from intrauterine premature closure of thesagittal,coronalandlambdoidsutures, through which the cranial contents bulge, giving rise to the characteristic trilobate shape (hence the name).
It is usually seen in the context of the following conditions:
thanatophoric dysplasia: classically type II only
severeApert syndrome
severeCrouzon syndrome
Boston-type craniosynostosis
Carpenter syndrome
Cloaca
Acloaca(pl. cloacae/cloacas) can be found in chronicosteomyelitis.
The cloaca is an opening in aninvolucrumwhich allows drainage of purulent and necrotic material out of the dead bone. If the tract extends to the skin surface, the portion extending beyond the involucrum to the skin surface is called asinus tract1.
Cingulate sulcus sign
Thecingulate sulcus signhas been proposed as being useful as an MRI feature of idiopathicnormal pressure hydrocephalus (NPH). It denotes the posterior part of thecingulate sulcusbeing narrower than the anterior part. The divider between the anterior and posterior parts of the sulcus being a line drawn parallel to the floor of the 4th ventricle1.
Claw sign
Theclaw signis useful in determining that a mass arises from a solid structure rather than is located adjacent to it and distorts the outline.
It refers to the sharp angles on either side of the mass,which the surrounding normal parenchyma forms when the mass has arisen from the parenchyma. As such, normal parenchyma extends some way around the mass.
Examples where a claw sign is useful include:
meningiomavsintra-axial brain tumor
Wilms tumorvsneuroblastoma
renal angiomyolipomavsretroperitoneal liposarcoma
Chorionic bump
Chorionic bump is a finding that can be uncommonly seen in afirst-trimester scan. It may represent a smallhematomabulging into thegestational sacor an anembryonic (failed) second pregnancy that is being resorbed. It is also seen in some patients undergoing infertility treatment.
Cheerio sign
Cheerio signin thoracic imaging relates to pulmonary nodules with a central lucent cavity as seen on CT. It is due to proliferation of (malignant or non-malignant) cells around an airway. They are so named because of their resemblance to the breakfast cereal,Cheerios1-2.
The Cheerio sign (pulmonary nodule) may be due to2:
lung adenocarcinoma(malignant)
pulmonary Langerhans cell histiocytosis(non-malignant)
pulmonary meningothelial-like nodules(non-malignant,rare)
Cavitating lung nodules are a differential diagnosis for the Cheerio sign2:
infection (fungal or mycobacterial)
primary lung cancer
pulmonary metastases
rheumatoid nodule
granulomatosis with polyangiitis
Dilated cardiomyopathy
Dilated cardiomyopathy (DCM)is defined asleft ventricularchamber dilation with decreased systolic function (FEVG <40%). There may also beright ventriculardysfunction.Causes are related to intrinsic myocardial damage.
Chilaiditi sign
Chilaiditi signrefers to the interposition of bowel, usually colon, between the inferior surface of the right hemidiaphragm and the superior surface of the liver. It may be misinterpreted as a truepneumoperitoneumresulting in unnecessary further investigations and/or therapy (so-calledpseudopneumoperitoneum). The presence of pain associated with and attributed to the sign is termedChilaiditi syndrome.
Crack lung
Crack lungis a term used to describe one of the respiratory complications of smoked crack cocaine.
Champagne glass pelvis
Thechampagne glass pelvisis a helpful sign inachondroplasiain which the iliac blades are flattened, giving rise to a pelvic inlet that resembles a champagne glass. Theacetabular anglesare flattened (horizontal) and the sacrosciatic notch is small.
Body packing
Body packingrefers to the internal concealment of drugs within thegastrointestinal tractor other orifices. People who do this may be calledbody packers,(drug)mules,stuffers,couriersorswallowers. Drugs may be concealed within condoms, foil, latex or cellophane.
Celery stalk sign
Thecelery stalk signis a term given to the appearance of theanterior cruciate ligamentwhich has undergonemucoid degenerationand has been likened to that of a celery stalk. Its low signal longitudinal fibers are separated from each other by higher signal mucinous material, best appreciated on T2 weighted images.
Cervicothoracic sign
Thecervicothoracic sign, a variation of thesilhouette sign, refers to visualization of a lesion above the level of the clavicle, indicating the abnormality is located posteriorly.
The anterior mediastinum ends at the level of theclavicles.Thus, the upper border of an anterior mediastinal lesion cannot extend above the clavicles. Any lesion with a discernible upper border above that level must be located posteriorly in the chest,i.e. apical segments of upper lobes, pleura, or posterior mediastinum3.
Celery stalk metaphysis
Celery stalk metaphysisrefers to a plain film appearance of the metaphyses in a number of conditions characterized by longitudinally aligned linear bands of sclerosis. They are seen in:
congenital infections
congenital rubella
congenital syphilis
congenital cytomegalovirus (CMV)
osteopathia striata
Centipede sign
Thecentipede signis seen as engorged mesenteric vessels in cases of acute sigmoiddiverticulitiswhich gives an appearance similar to a centipede1.
“Cervix Sign” -Congenital Hypertrophic Pyloric Stenosis
- stenosisdescribes indentation of the pylorus into the fluid-filled antrum.
Caton-Deschamps index
TheCaton-Deschamps indexis a ratio that is used in everyday practice as well as in research to measure patellar height and allows the diagnosis ofpatella altaandpatella baja.
Radiographic features
The Caton-Deschamps index is the ratio between the distance between the lower pole of thepatellaand the upper limit of thetibia,and the length of the patellar joint surface.
normal range 0.6-1.3
patella baja:<0.6
patella alta: >1.3
Cartilage interface sign
Cartilage interface sign, also referred to asdouble cortex sign, refers to the sonographic presence of a thin markedly hyperechoic line at the interface between the normally hypoechoic hyaline articular cartilage of the humeral head and an abnormally hypoechoicsupraspinatus tendon. This arises due to the marked difference in acoustic impedances of the two tissues at the interface1. The sign indicates the presence ofpartial or complete supraspinatus tearwith fluid replacing the fibers and has been shown to be 100% specific2. However, it is not often present and has a low sensitivity for supraspinatus tear,around 30%2.
Carman meniscus sign
TheCarman meniscus signdescribes the lenticular shape of barium in cases of large and flatgastric ulcers, in which the inner margin is convex toward the lumen. It usually indicates a malignant ulcerated neoplasm; in cases of benign gastric ulcers, the inner margin is usually concave toward the lumen1.
Carman meniscus signis seen after compression of a gastric tumor that surrounds the lesser curvature thus apposing both surfaces of the surrounding tumor and entrapping contrast between these margins causing a semilunar configuration2,3.
