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Classical Radiological Signs:Apple core lesion or Napkin Ring sign: in right hip synovial chondromatosis .

Same
can be viewed in colonic Ca.... seems like eaten apple.

Bamboo Spine: fused spinal segments with their syndesmophytes look, on radiographs,
similar to bamboo stalks. Classically associated with ankylosing spondylitis.

Bird's Beak: noted on Upper GI with contrast, a dilated upper/middle


esophagus with an abrupt taper to exceptionally narrowed lumen, typical of achalasia.

Boot-shaped Heart: due to RVH, the LV is lifted above the edge of the
diaphragm, forming the toe of the boot. Classic for Tetralogy of Fallot.

Bat's Wing/Butterfly: this appearance on CXR is classically associated with CHF


and resultant pulmonary edema.

Cobblestone appearance: this sign is produced on barium studies due to


ulcerative pockets, usually in the terminal ileum, indicative of Crohn's.

Codman's Triangle: a triangle on plain film of extremities that signifies reactive


bone, classically associated with osteosarcoma, or other infectious, hemorrhagic process that causes periosteal elevation.

Coin lesion: solitary pulmonary nodule; may be cancer or granuloma. Cookie Cutter lesions: metastatic lesions to bone cortex, or Paget's. Crescent sign: classic sign of avascular necrosis, femoral head. Egg-on-a-string: a large, ovoid-shaped heart on newborn CXR, classically
signifying complete transposition of the great vessels with intact ventricular septum.

Ground glass: a white-out on CXR, usually PCP pneumonia or ARDS. Hampton's Hump: a peripheral triangle, usually near pleural edges, classically
PE.

Honeycomb lung: used to describe any pathologic process that causes


radiographic appearance of multiple small, thick-walled cystic spaces; e.g. pulmonary fibrosis.

Lead pipe sign: classic narrowing of bowel lumen, with loss of haustraUC.
Napkin Ring sign: see Apple core lesion above; pathology identical, but lumen more narrowed.

Onion-skinning: layered look of periosteum in Ewing's Sarcoma.

Rachitic Rosary: this is a string of beads appearance on x-ray, a thickening


of costochondral margins that is noted in Ricketts (Vit. D Deficiency).

Sail sign: fat pad noted on plain film, indicative of shoulder dislocation. Scotty dog (collar) : on posterior oblique, the lumbar vertebrae look like a
Scottish terrier. The neck is the pars interarticularis, and a break(a collar) noted there indicates spondylolysis.

String sign: thin, slightly irregular shadow in narrowed lumen of ileum,


suggestive of Crohn's.

Silhouette sign: obliteration of cardiovascular silhouette due to adjacent


disease, ie pneumonia, TB, etc.

Stepladder appearance: distended bowel loops, often indicative of obstruction,


usually SBO.

Sunburst appearance: clouds, clumps, and consolidated rays of tissue


emanating from bone cortex, or within bony structures, indicative of osteosarcoma.

Thumb (print) sign: on lateral c-spine, an enlarged epiglottis appears as a


thumb epiglottitis.

Westermarcks sign : abrupt end to a pulmonary vessel, signifying oligemia or


PE

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