radiological signs (shënja radiologjike )-4

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    Sllavko K. Kallfa

    Radiological Signs

    Shnja Radiologjike)

    Prmbledhje Artikujsh nga

    Radiopaedia.org

    4

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    poultry and fowl

    X-ray signs

    o beak sign........................................f.3

    o beak sign of sigmoid volvulusf.4

    o bird-beak sign................................f.6

    o eggshell calcification......................f.20

    o gull wing appearance.....................f.28

    o hummingbird sign.........................f.36

    o sitting duck appearance................f.42

    o swan neck deformity.....................f.43

    http://radiopaedia.org/articles/beak-sign-of-arterial-dissectionhttp://radiopaedia.org/articles/sigmoid-volvulushttp://radiopaedia.org/articles/bird-beak-signhttp://radiopaedia.org/articles/eggshell-calcificationhttp://radiopaedia.org/articles/gull-wing-appearancehttp://radiopaedia.org/articles/hummingbird-signhttp://radiopaedia.org/articles/sitting-duck-appearance-2http://radiopaedia.org/articles/swan-neck-deformityhttp://radiopaedia.org/articles/swan-neck-deformityhttp://radiopaedia.org/articles/sitting-duck-appearance-2http://radiopaedia.org/articles/hummingbird-signhttp://radiopaedia.org/articles/gull-wing-appearancehttp://radiopaedia.org/articles/eggshell-calcificationhttp://radiopaedia.org/articles/bird-beak-signhttp://radiopaedia.org/articles/sigmoid-volvulushttp://radiopaedia.org/articles/beak-sign-of-arterial-dissection
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    Beak sign of arterial dissection

    Dr Jeremy JonesandDr Yale Rosenet al.

    The beak signofarterial dissectionrepresents a wedge of haematoma at the distal end of thefalse lumen. It is here that false lumen propagation is occurring. It manifest as an acute anglebetween the dissection flap and the outer wall. It may be filled with contrast enhanced blood

    (high attenuation) or thrombus (low attenuation)

    References

    1. LePage MA, Quint LE, Sonnad SS et-al. Aortic dissection: CT features that distinguish

    true lumen from false lumen. AJR Am J Roentgenol. 2001;177 (1): 207-11.AJR Am JRoentgenol (full text)[pubmed citation]

    http://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/yrosenhttp://radiopaedia.org/users/yrosenhttp://radiopaedia.org/users/yrosenhttp://radiopaedia.org/articles/arterial-dissectionhttp://radiopaedia.org/articles/arterial-dissectionhttp://radiopaedia.org/articles/arterial-dissectionhttp://www.ajronline.org/cgi/content/full/177/1/207http://www.ajronline.org/cgi/content/full/177/1/207http://www.ajronline.org/cgi/content/full/177/1/207http://www.ajronline.org/cgi/content/full/177/1/207http://www.ncbi.nlm.nih.gov/pubmed/11418429http://www.ncbi.nlm.nih.gov/pubmed/11418429http://www.ncbi.nlm.nih.gov/pubmed/11418429http://www.ncbi.nlm.nih.gov/pubmed/11418429http://www.ajronline.org/cgi/content/full/177/1/207http://www.ajronline.org/cgi/content/full/177/1/207http://radiopaedia.org/articles/arterial-dissectionhttp://radiopaedia.org/users/yrosenhttp://radiopaedia.org/users/drjermy
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    Sigmoid volvulus

    Dr Henry KnipeandDr Jeremy Joneset al.

    Sigmoid volvulusis a cause oflarge bowel obstructionand occurs when thesigmoid colontortes on thesigmoid mesocolon.

    Epidemiology

    Large bowel volvulus accounts for ~5% of all large bowel obstructions, with ~60% ofintestinal

    volvulusinvolving thesigmoid colon6. It is more common in the elderly

    7.

    Clinical presentation

    Symptoms are that of a large bowel obstruction - constipation, abdominal bloating, nausea and/or

    vomiting. Onset may be acute or chronic.

    Pathology

    Aetiology

    There is a wide range of causes, some are region-specific5:

    chronic constipation and/or laxative abuse

    fibre-rich diet (especially in Africa)

    Chagas disease(especially in South America)

    Associations

    chronic neurological conditions (e.g.Parkinson disease,multiple sclerosis,pseudobulbarpalsy)

    chronic psychiatric conditions (e.g. chronic schizophrenia)

    Radiographic features

    Sigmoid volvulus is differentiated from acaecal volvulusby its ahaustral wall and the lower end

    pointing topelvis.

    Plain film

    Abdominal radiographs will demonstrated a large, dilated loop of colon, often with a fewair-

    fluid levels.Specific signs include:

    coffee bean sign5

    Frimann Dahl's sign- three dense lines converge towards site of obstruction

    absent rectal gas5

    http://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/drjermyhttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/sigmoid-mesocolonhttp://radiopaedia.org/articles/sigmoid-mesocolonhttp://radiopaedia.org/articles/sigmoid-mesocolonhttp://radiopaedia.org/articles/intestinal-volvulushttp://radiopaedia.org/articles/intestinal-volvulushttp://radiopaedia.org/articles/intestinal-volvulushttp://radiopaedia.org/articles/intestinal-volvulushttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/chagas-diseasehttp://radiopaedia.org/articles/chagas-diseasehttp://radiopaedia.org/articles/parkinsons-diseasehttp://radiopaedia.org/articles/parkinsons-diseasehttp://radiopaedia.org/articles/parkinsons-diseasehttp://radiopaedia.org/articles/multiple-sclerosishttp://radiopaedia.org/articles/multiple-sclerosishttp://radiopaedia.org/articles/multiple-sclerosishttp://radiopaedia.org/articles/pseudobulbar-palsyhttp://radiopaedia.org/articles/pseudobulbar-palsyhttp://radiopaedia.org/articles/pseudobulbar-palsyhttp://radiopaedia.org/articles/pseudobulbar-palsyhttp://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/pelvis-1http://radiopaedia.org/articles/pelvis-1http://radiopaedia.org/articles/pelvis-1http://radiopaedia.org/articles/missing?article%5Btitle%5D=air-fluid-levelhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=air-fluid-levelhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=air-fluid-levelhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=air-fluid-levelhttp://radiopaedia.org/articles/coffee-bean-sign-3http://radiopaedia.org/articles/coffee-bean-sign-3http://radiopaedia.org/articles/missing?article%5Btitle%5D=frimann-dahl-s-signhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=frimann-dahl-s-signhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=frimann-dahl-s-signhttp://radiopaedia.org/articles/coffee-bean-sign-3http://radiopaedia.org/articles/missing?article%5Btitle%5D=air-fluid-levelhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=air-fluid-levelhttp://radiopaedia.org/articles/pelvis-1http://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/pseudobulbar-palsyhttp://radiopaedia.org/articles/pseudobulbar-palsyhttp://radiopaedia.org/articles/multiple-sclerosishttp://radiopaedia.org/articles/parkinsons-diseasehttp://radiopaedia.org/articles/chagas-diseasehttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/intestinal-volvulushttp://radiopaedia.org/articles/intestinal-volvulushttp://radiopaedia.org/articles/sigmoid-mesocolonhttp://radiopaedia.org/articles/sigmoid-colonhttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/henryknipe
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    Fluoroscopy

    Although now uncommonly performed, a water soluble contrast enema exquisitely demonstratesthis condition, with the appearances described as the bird of prey sign.

    CT

    large gas-filled loop withouthaustral markings,forming aclosed-loop obstruction6, 7

    whirl sign- twisting of the mesentery and mesenteric vessels

    beak sign- if rectal contrast has been administered6

    Treatment and prognosis

    Rectal tube insertion is successful in successful in treating 90% of cases5. Mortality rate is 20-

    25%7. The most serious complication isbowel ischaemia.

    Differential diagnosis

    large bowel obstructionfrom other causes

    caecal volvulus

    colonic pseudo-obstruction

    References

    1. Janzen DL, Heap SW. Organo-axial volvulus of the sigmoid colon. Australas Radiol.

    1992;36 (4): 332-3. -Pubmed citation

    2. Catalano O. Computed tomographic appearance of sigmoid volvulus. Abdom Imaging.

    21 (4): 314-7.Abdom Imaging (link)-Pubmed citation 3. Levsky JM, Den EI, Dubrow RA et-al. CT findings of sigmoid volvulus. AJR Am J

    Roentgenol. 2010;194 (1): 136-43.doi:10.2214/AJR.09.2580-Pubmed citation

    4. Burrell HC, Baker DM, Wardrop P et-al. Significant plain film findings in sigmoid

    volvulus. Clin Radiol. 1994;49 (5): 317-9. -Pubmed citation

    5. Salati U, Mcneill G, Torreggiani WC. The coffee bean sign in sigmoid volvulus.

    Radiology. 2011;258 (2): 651-2.doi:10.1148/radiol.101882-Pubmed citation

    6. Vandendries C, Julls MC, Boulay-Coletta I et-al. Diagnosis of colonic volvulus:

    findings on multidetector CT with three-dimensional reconstructions. Br J Radiol.

    2010;83 (995): 983-90.doi:10.1259/bjr/35714052-Free text at pubmed-Pubmed

    citation

    7. Brant WE, Helms CA. Fundamentals of Diagnostic Radiology. Lippincott Williams &Wilkins. (2007) ISBN:0781761352.Read it at Google Books-Find it at Amazon

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Sigmoid colon volvulus

    http://radiopaedia.org/articles/haustral-markingshttp://radiopaedia.org/articles/haustral-markingshttp://radiopaedia.org/articles/haustral-markingshttp://radiopaedia.org/articles/closed-loop-obstructionhttp://radiopaedia.org/articles/closed-loop-obstructionhttp://radiopaedia.org/articles/closed-loop-obstructionhttp://radiopaedia.org/articles/whirlpool-signhttp://radiopaedia.org/articles/whirlpool-signhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=beak-sign-of-sigmoid-volvulushttp://radiopaedia.org/articles/missing?article%5Btitle%5D=beak-sign-of-sigmoid-volvulushttp://radiopaedia.org/articles/intestinal-ischaemiahttp://radiopaedia.org/articles/intestinal-ischaemiahttp://radiopaedia.org/articles/intestinal-ischaemiahttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/colonic-pseudoobstructionhttp://radiopaedia.org/articles/colonic-pseudoobstructionhttp://www.ncbi.nlm.nih.gov/pubmed/1299196http://www.ncbi.nlm.nih.gov/pubmed/1299196http://www.ncbi.nlm.nih.gov/pubmed/1299196http://link.springer-ny.com/link/service/journals/00261/bibs/21n4p314.htmlhttp://link.springer-ny.com/link/service/journals/00261/bibs/21n4p314.htmlhttp://link.springer-ny.com/link/service/journals/00261/bibs/21n4p314.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/8661573http://www.ncbi.nlm.nih.gov/pubmed/8661573http://www.ncbi.nlm.nih.gov/pubmed/8661573http://dx.doi.org/10.2214/AJR.09.2580http://dx.doi.org/10.2214/AJR.09.2580http://dx.doi.org/10.2214/AJR.09.2580http://www.ncbi.nlm.nih.gov/pubmed/20028915http://www.ncbi.nlm.nih.gov/pubmed/20028915http://www.ncbi.nlm.nih.gov/pubmed/20028915http://www.ncbi.nlm.nih.gov/pubmed/8013194http://www.ncbi.nlm.nih.gov/pubmed/8013194http://www.ncbi.nlm.nih.gov/pubmed/8013194http://dx.doi.org/10.1148/radiol.101882http://dx.doi.org/10.1148/radiol.101882http://dx.doi.org/10.1148/radiol.101882http://www.ncbi.nlm.nih.gov/pubmed/21273530http://www.ncbi.nlm.nih.gov/pubmed/21273530http://www.ncbi.nlm.nih.gov/pubmed/21273530http://dx.doi.org/10.1259/bjr/35714052http://dx.doi.org/10.1259/bjr/35714052http://dx.doi.org/10.1259/bjr/35714052http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473716http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473716http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473716http://www.ncbi.nlm.nih.gov/pubmed/20965909http://www.ncbi.nlm.nih.gov/pubmed/20965909http://www.ncbi.nlm.nih.gov/pubmed/20965909http://www.ncbi.nlm.nih.gov/pubmed/20965909http://books.google.com/books?vid=ISBN0781761352http://books.google.com/books?vid=ISBN0781761352http://books.google.com/books?vid=ISBN0781761352http://www.amazon.com/gp/product/0781761352http://www.amazon.com/gp/product/0781761352http://www.amazon.com/gp/product/0781761352http://www.amazon.com/gp/product/0781761352http://books.google.com/books?vid=ISBN0781761352http://www.ncbi.nlm.nih.gov/pubmed/20965909http://www.ncbi.nlm.nih.gov/pubmed/20965909http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473716http://dx.doi.org/10.1259/bjr/35714052http://www.ncbi.nlm.nih.gov/pubmed/21273530http://dx.doi.org/10.1148/radiol.101882http://www.ncbi.nlm.nih.gov/pubmed/8013194http://www.ncbi.nlm.nih.gov/pubmed/20028915http://dx.doi.org/10.2214/AJR.09.2580http://www.ncbi.nlm.nih.gov/pubmed/8661573http://link.springer-ny.com/link/service/journals/00261/bibs/21n4p314.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/1299196http://radiopaedia.org/articles/colonic-pseudoobstructionhttp://radiopaedia.org/articles/caecal-volvulushttp://radiopaedia.org/articles/large-bowel-obstructionhttp://radiopaedia.org/articles/intestinal-ischaemiahttp://radiopaedia.org/articles/missing?article%5Btitle%5D=beak-sign-of-sigmoid-volvulushttp://radiopaedia.org/articles/whirlpool-signhttp://radiopaedia.org/articles/closed-loop-obstructionhttp://radiopaedia.org/articles/haustral-markings
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    Bird-beak sign

    Dr Jeremy JonesandDr Frank Gaillardet al.

    The bird-beak signis used to refer to the tapering of the inferior oesophagus inachalasia.Thesame appearance (although it is difficult to see the similarity) is also referred to as therat-tailsign.

    The appearances although classically occurring in primary achalasia, can also occur in

    pseudoachalasiadue to a gastric tumour involving the gastro-oseophageal junction.

    References

    1. Patil KK, Telmesani A, Ogunbiyi OA. Childhood achalasia-a case report. West Afr J

    Med. 1994;12 (3): 172-4.Pubmed citation

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Bird beak sign

    http://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/drjermyhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/achalasiahttp://radiopaedia.org/articles/achalasiahttp://radiopaedia.org/articles/achalasiahttp://radiopaedia.org/articles/rat-tail-signhttp://radiopaedia.org/articles/rat-tail-signhttp://radiopaedia.org/articles/rat-tail-signhttp://radiopaedia.org/articles/rat-tail-signhttp://radiopaedia.org/articles/pseudoachalasiahttp://radiopaedia.org/articles/pseudoachalasiahttp://www.ncbi.nlm.nih.gov/pubmed/8312217http://www.ncbi.nlm.nih.gov/pubmed/8312217http://www.ncbi.nlm.nih.gov/pubmed/8312217http://www.ncbi.nlm.nih.gov/pubmed/8312217http://radiopaedia.org/articles/pseudoachalasiahttp://radiopaedia.org/articles/rat-tail-signhttp://radiopaedia.org/articles/rat-tail-signhttp://radiopaedia.org/articles/achalasiahttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/drjermy
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    Bird Beak Bird head (with

    beak) for bird-beak sign of achalasia. Author: DschwenOriginal file:

    http://commons.wikimedia.org/wiki/File:Gull_portrait_ca_usa.jpgI, the copyright holder of this

    work, hereby publish it under the following licenses: Permission is granted to copy, distribute

    and/or modify this document under the terms of the GNU Free Documentation License, Version

    1.2 or any later version published by the Free Software Foundation; with no Invariant Sections,

    no Front-Cover Texts, and no Back-Cover Texts. A copy of the license is included in the section

    entitled "GNU Free Documentation License".

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    Achalasia

    From the case:Achalasia

    Modality: X-ray

    http://radiopaedia.org/cases/achalasia-3http://radiopaedia.org/cases/achalasia-3http://radiopaedia.org/cases/achalasia-3http://radiopaedia.org/cases/achalasia-3
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    From the case:Achalasia

    Modality: X-ray

    http://radiopaedia.org/cases/achalasia-3http://radiopaedia.org/cases/achalasia-3http://radiopaedia.org/cases/achalasia-3http://radiopaedia.org/cases/achalasia-3
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    From the case:Cardiac

    achalasia

    Modality: Barium

    http://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasia
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    From the case:Cardiac

    achalasia

    Modality: Barium

    http://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasiahttp://radiopaedia.org/cases/cardiac-achalasia
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    From the case:

    Achalasia

    Modality: Barium

    http://radiopaedia.org/cases/achalasia-9http://radiopaedia.org/cases/achalasia-9http://radiopaedia.org/cases/achalasia-9
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    Eggshell calcification

    Dr Frank Gaillardet al.

    Eggshell calcificationrefers to fine calcification seen at the periphery of a mass, and usuallyrelates to lymph node calcification.

    In 1967 Jacobsen and Felson published criteria to help "avoid over-reading of the incidentalcircumferential concentrations of calcium and to eliminate confusion with the ring shadows of

    bronchi on end." These criteria were:

    shell-like calcifications up to 2 mm thick must be present in the peripheral zone of at least

    two lymph nodes

    the calcifications may be solid or broken

    in at least one of the lymph nodes the ringlike shadow must be complete

    the central part of the lymph node may show additional calcifications one of the affected lymph nodes must be at least 1 cm in its greatest diameter

    Causes include

    In the mediastinum and thorax

    silicosis- 5% patients

    treatedlymphoma:(postirradiationHodgkin disease)usually 1-9 years following

    treatment

    coal workers' pneumoconiosis (CWP)- 1% patients

    sarcoidosis- calcification is uncommon (only 5% of patients) and occurs late in the

    disease; only rarely does it have eggshell configuration

    scleroderma

    amyloidosis- rare

    blastomycosis(e.g.pulmonary blastomycosis)- rare

    histoplasmosis(e.g.pulmonary histoplasmosis)- rare

    In the breast

    oil cysts -inegg-shell calcification within the breast

    Differential diagnosis

    For eggshell like calcification appearances in the thorax consider

    aneurysms

    parathyroid tumours

    pulmonary arteries inpulmonary arterial hypertension

    thymic cysts

    http://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/silicosishttp://radiopaedia.org/articles/silicosishttp://radiopaedia.org/articles/lymphomahttp://radiopaedia.org/articles/lymphomahttp://radiopaedia.org/articles/lymphomahttp://radiopaedia.org/articles/hodgkin-lymphomahttp://radiopaedia.org/articles/hodgkin-lymphomahttp://radiopaedia.org/articles/hodgkin-lymphomahttp://radiopaedia.org/articles/coal_workers%27_pneumoconiosishttp://radiopaedia.org/articles/coal_workers%27_pneumoconiosishttp://radiopaedia.org/articles/sarcoidosis-1http://radiopaedia.org/articles/sarcoidosis-1http://radiopaedia.org/articles/sclerodermahttp://radiopaedia.org/articles/sclerodermahttp://radiopaedia.org/articles/amyloidosishttp://radiopaedia.org/articles/amyloidosishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=blastomycosishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=blastomycosishttp://radiopaedia.org/articles/pulmonary-blastomycosishttp://radiopaedia.org/articles/pulmonary-blastomycosishttp://radiopaedia.org/articles/pulmonary-blastomycosishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=histoplasmosishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=histoplasmosishttp://radiopaedia.org/articles/thoracic-histoplasmosis-1http://radiopaedia.org/articles/thoracic-histoplasmosis-1http://radiopaedia.org/articles/thoracic-histoplasmosis-1http://radiopaedia.org/articles/oil-cysthttp://radiopaedia.org/articles/oil-cysthttp://radiopaedia.org/articles/egg-shell-calcification-within-the-breasthttp://radiopaedia.org/articles/egg-shell-calcification-within-the-breasthttp://radiopaedia.org/articles/egg-shell-calcification-within-the-breasthttp://radiopaedia.org/articles/missing?article%5Btitle%5D=parathyroid+tumourshttp://radiopaedia.org/articles/missing?article%5Btitle%5D=parathyroid+tumourshttp://radiopaedia.org/articles/pulmonary-hypertension-1http://radiopaedia.org/articles/pulmonary-hypertension-1http://radiopaedia.org/articles/pulmonary-hypertension-1http://radiopaedia.org/articles/thymic-cystshttp://radiopaedia.org/articles/thymic-cystshttp://radiopaedia.org/articles/thymic-cystshttp://radiopaedia.org/articles/pulmonary-hypertension-1http://radiopaedia.org/articles/missing?article%5Btitle%5D=parathyroid+tumourshttp://radiopaedia.org/articles/egg-shell-calcification-within-the-breasthttp://radiopaedia.org/articles/oil-cysthttp://radiopaedia.org/articles/thoracic-histoplasmosis-1http://radiopaedia.org/articles/missing?article%5Btitle%5D=histoplasmosishttp://radiopaedia.org/articles/pulmonary-blastomycosishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=blastomycosishttp://radiopaedia.org/articles/amyloidosishttp://radiopaedia.org/articles/sclerodermahttp://radiopaedia.org/articles/sarcoidosis-1http://radiopaedia.org/articles/coal_workers%27_pneumoconiosishttp://radiopaedia.org/articles/hodgkin-lymphomahttp://radiopaedia.org/articles/lymphomahttp://radiopaedia.org/articles/silicosishttp://radiopaedia.org/users/frank
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    thyroid tumoursandmultinodular goitre

    References

    1. Weissleder R. Primer of diagnostic imaging. Mosby Inc. (2007) ISBN:0323040683.

    Read it at Google Books-Find it at Amazon 2. Wright FW. Radiology of the Chest and Related Conditions. CRC. (2001)

    ISBN:0415281415.Read it at Google Books-Find it at Amazon

    3. Gross BH, Schneider HJ, Proto AV. Eggshell calcification of lymph nodes: an update.

    AJR Am J Roentgenol. 1980;135 (6): 1265-8.AJR Am J Roentgenol (citation)-Pubmed

    citation

    4. Jacobson G, Felson B et al "Eggshell calcifications in coal and metal miners." Semin

    Roentgenol 1967; 2: 276-282

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Eggshell calcifications

    Eggshell calcifications - general

    http://radiopaedia.org/articles/assessment-of-thyroid-lesionshttp://radiopaedia.org/articles/assessment-of-thyroid-lesionshttp://radiopaedia.org/articles/missing?article%5Btitle%5D=multinodular-goiterhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=multinodular-goiterhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=multinodular-goiterhttp://books.google.com/books?vid=ISBN0323040683http://books.google.com/books?vid=ISBN0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://books.google.com/books?vid=ISBN0415281415http://books.google.com/books?vid=ISBN0415281415http://books.google.com/books?vid=ISBN0415281415http://www.amazon.com/gp/product/0415281415?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0415281415http://www.amazon.com/gp/product/0415281415?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0415281415http://www.amazon.com/gp/product/0415281415?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0415281415http://www.ajronline.org/cgi/content/citation/135/6/1265http://www.ajronline.org/cgi/content/citation/135/6/1265http://www.ajronline.org/cgi/content/citation/135/6/1265http://www.ncbi.nlm.nih.gov/pubmed/6779537http://www.ncbi.nlm.nih.gov/pubmed/6779537http://www.ncbi.nlm.nih.gov/pubmed/6779537http://www.ncbi.nlm.nih.gov/pubmed/6779537http://www.ncbi.nlm.nih.gov/pubmed/6779537http://www.ncbi.nlm.nih.gov/pubmed/6779537http://www.ajronline.org/cgi/content/citation/135/6/1265http://www.amazon.com/gp/product/0415281415?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0415281415http://books.google.com/books?vid=ISBN0415281415http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://books.google.com/books?vid=ISBN0323040683http://radiopaedia.org/articles/missing?article%5Btitle%5D=multinodular-goiterhttp://radiopaedia.org/articles/assessment-of-thyroid-lesions
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    Egg Photo by Ren West. This file is licensed by the author under Creative Commons NC BY SA 2.0

    License. Visit case page for links.

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    From the case:

    Silicosis

    Modality: CT

    http://radiopaedia.org/cases/silicosishttp://radiopaedia.org/cases/silicosishttp://radiopaedia.org/cases/silicosis
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    From the case:

    Silicosis

    Modality: CT

    http://radiopaedia.org/cases/silicosishttp://radiopaedia.org/cases/silicosishttp://radiopaedia.org/cases/silicosis
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    From the case:Calcified oil cyst in right breast on CT

    Modality: CT

    http://radiopaedia.org/cases/calcified-oil-cyst-in-right-breast-on-cthttp://radiopaedia.org/cases/calcified-oil-cyst-in-right-breast-on-cthttp://radiopaedia.org/cases/calcified-oil-cyst-in-right-breast-on-cthttp://radiopaedia.org/cases/calcified-oil-cyst-in-right-breast-on-ct
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    Gull wing appearance

    Dr Henry KnipeandDr MT Niknejadet al.

    Gull-wing appearanceis seen aterosive osteoarthritis on posteroanterior (PA) radiographs. Thecombination of cartilage space loss, subchondral central erosions, and marginalproliferation (osteophyte formation) results in a gull-wing appearance.

    References

    1. Chew FS. Radiology of the hands: review and self-assessment module. AJR Am J

    Roentgenol. 2005;184 (6): S157-68.AJR Am J Roentgenol (full text)-Pubmed citation

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Gull's wing appearance

    Gull-wing appearance

    http://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/dr%20mt%20niknejadhttp://radiopaedia.org/users/dr%20mt%20niknejadhttp://radiopaedia.org/users/dr%20mt%20niknejadhttp://radiopaedia.org/articles/erosive-osteoarthritishttp://radiopaedia.org/articles/erosive-osteoarthritishttp://www.ajronline.org/cgi/content/full/184/6_supp/S157http://www.ajronline.org/cgi/content/full/184/6_supp/S157http://www.ajronline.org/cgi/content/full/184/6_supp/S157http://www.ncbi.nlm.nih.gov/pubmed/15908517http://www.ncbi.nlm.nih.gov/pubmed/15908517http://www.ncbi.nlm.nih.gov/pubmed/15908517http://www.ncbi.nlm.nih.gov/pubmed/15908517http://www.ajronline.org/cgi/content/full/184/6_supp/S157http://radiopaedia.org/articles/erosive-osteoarthritishttp://radiopaedia.org/users/dr%20mt%20niknejadhttp://radiopaedia.org/users/henryknipe
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    From the case:Seagull flying photo (creative commons)

    Modality: Photo

    http://radiopaedia.org/cases/seagull-flying-photo-creative-commonshttp://radiopaedia.org/cases/seagull-flying-photo-creative-commonshttp://radiopaedia.org/cases/seagull-flying-photo-creative-commonshttp://radiopaedia.org/cases/seagull-flying-photo-creative-commons
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    From the case:Gull-

    wing appearance - erosive osteoarthritis

    Modality: X-ray

    http://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritis
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    From the case:Gull-

    wing appearance - erosive osteoarthritis

    Modality: X-ray

    http://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritishttp://radiopaedia.org/cases/gull-wing-appearance-erosive-osteoarthritis
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    From the case:Erosive osteoarthritis

    Modality: X-ray

    http://radiopaedia.org/cases/erosive-osteoarthritis-3http://radiopaedia.org/cases/erosive-osteoarthritis-3http://radiopaedia.org/cases/erosive-osteoarthritis-3http://radiopaedia.org/cases/erosive-osteoarthritis-3
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    From the case:Erosive osteoarthritis

    Modality: X-ray

    http://radiopaedia.org/cases/erosive-osteoarthritis-3http://radiopaedia.org/cases/erosive-osteoarthritis-3http://radiopaedia.org/cases/erosive-osteoarthritis-3http://radiopaedia.org/cases/erosive-osteoarthritis-3
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    Hummingbird sign

    Dr Frank Gaillardet al.

    The hummingbird sign, also known as the penguin sign, refers to the appearance of thebrainstem in patients withprogressive supranuclear palsy (PSP).

    The atrophy of the midbrain results in a profile of the brainstem ( in the sagittal plane ) in whichthe persevered pons forms the body of the bird, and the atrophic midbrain the head, with beak

    extending anteriorly towards the optic chiasm.

    References

    1. Grschel K, Kastrup A, Litvan I et-al. Penguins and hummingbirds: midbrain atrophy

    in progressive supranuclear palsy. Neurology. 2006;66 (6): 949-50.

    doi:10.1212/01.wnl.0000203342.77115.bf-Pubmed citation 2. Shukla R, Sinha M, Kumar R et-al. 'Hummingbird' sign in progressive supranuclear

    palsy. Ann Indian Acad Neurol. 2009;12 (2): 133.doi:10.4103/0972-2327.53087-Freetext at pubmed-Pubmed citation

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Penguin sign

    http://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/progressive-supranuclear-palsy-1http://radiopaedia.org/articles/progressive-supranuclear-palsy-1http://radiopaedia.org/articles/progressive-supranuclear-palsy-1http://dx.doi.org/10.1212/01.wnl.0000203342.77115.bfhttp://dx.doi.org/10.1212/01.wnl.0000203342.77115.bfhttp://www.ncbi.nlm.nih.gov/pubmed/16567726http://www.ncbi.nlm.nih.gov/pubmed/16567726http://www.ncbi.nlm.nih.gov/pubmed/16567726http://dx.doi.org/10.4103/0972-2327.53087http://dx.doi.org/10.4103/0972-2327.53087http://dx.doi.org/10.4103/0972-2327.53087http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812742http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812742http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812742http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812742http://www.ncbi.nlm.nih.gov/pubmed/20142864http://www.ncbi.nlm.nih.gov/pubmed/20142864http://www.ncbi.nlm.nih.gov/pubmed/20142864http://www.ncbi.nlm.nih.gov/pubmed/20142864http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812742http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812742http://dx.doi.org/10.4103/0972-2327.53087http://www.ncbi.nlm.nih.gov/pubmed/16567726http://dx.doi.org/10.1212/01.wnl.0000203342.77115.bfhttp://radiopaedia.org/articles/progressive-supranuclear-palsy-1http://radiopaedia.org/users/frank
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    From

    the case:Progressive supranuclear palsy - with hummingbird or penguin sign

    Modality: MRI

    http://radiopaedia.org/cases/progressive-supranuclear-palsy-with-hummingbird-or-penguin-signhttp://radiopaedia.org/cases/progressive-supranuclear-palsy-with-hummingbird-or-penguin-signhttp://radiopaedia.org/cases/progressive-supranuclear-palsy-with-hummingbird-or-penguin-signhttp://radiopaedia.org/cases/progressive-supranuclear-palsy-with-hummingbird-or-penguin-sign
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    T1

    From the case:Hummingbird sign in PSP

    Modality: MRI

    http://radiopaedia.org/cases/hummingbird-sign-in-psphttp://radiopaedia.org/cases/hummingbird-sign-in-psphttp://radiopaedia.org/cases/hummingbird-sign-in-psphttp://radiopaedia.org/cases/hummingbird-sign-in-psp
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    From the case:Progressive supranuclear palsy

    Modality: CT

    http://radiopaedia.org/cases/progressive-supranuclear-palsyhttp://radiopaedia.org/cases/progressive-supranuclear-palsyhttp://radiopaedia.org/cases/progressive-supranuclear-palsyhttp://radiopaedia.org/cases/progressive-supranuclear-palsy
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    Sitting duck appearance

    Dr Henry KnipeandDr Mohammed Wahba et al.

    The sitting duck appearancedenotes the normal anatomical configuration of thejugularforamen:

    the head of the duck (pointing backwards on the right side) represents the anteromedialpars nervosa

    the body of the duck representing thepars vascularis

    References

    1. Swartz JD, Loevner LA. Imaging of the Temporal Bone. Thieme. (2009)

    ISBN:1588903451.Read it at Google Books-Find it at Amazon

    Annotated CT at the level of

    the jugular foramen.

    http://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/genish1http://radiopaedia.org/users/genish1http://radiopaedia.org/users/genish1http://radiopaedia.org/articles/jugular-foramen-2http://radiopaedia.org/articles/jugular-foramen-2http://radiopaedia.org/articles/jugular-foramen-2http://radiopaedia.org/articles/jugular-foramen-2http://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-nervosahttp://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-nervosahttp://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-vascularishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-vascularishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-vascularishttp://books.google.com/books?vid=ISBN1588903451http://books.google.com/books?vid=ISBN1588903451http://books.google.com/books?vid=ISBN1588903451http://www.amazon.com/gp/product/1588903451http://www.amazon.com/gp/product/1588903451http://www.amazon.com/gp/product/1588903451http://www.amazon.com/gp/product/1588903451http://books.google.com/books?vid=ISBN1588903451http://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-vascularishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=pars-nervosahttp://radiopaedia.org/articles/jugular-foramen-2http://radiopaedia.org/articles/jugular-foramen-2http://radiopaedia.org/users/genish1http://radiopaedia.org/users/henryknipe
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    Swan neck deformity

    Dr MT Niknejadet al.

    The swan neck deformityis one of the musculoskeletal manifestation ofrheumatoid arthritisinhand with:

    hyperextension of the proximal interphalangeal (PIP) joints, and

    compensatory flexion of the distal interphalangeal (DIP) joints

    References

    1. Longo D, Fauci AS, Kasper D et-al. Harrison's Principles of Internal Medicine.

    McGraw-Hill Professional Pub. (2011) ISBN:007174889X.Read it at Google Books-Find it at Amazon

    2. Weissleder R, Wittenberg J, Harisinghani MG. Primer of diagnostic imaging. Mosby

    Inc. (2007) ISBN:0323040683.Read it at Google Books-Find it at Amazon

    Synonyms & Alternative SpellingsSynonyms or Alternative Spelling Include in Listings?

    Swan neck type deformity

    http://radiopaedia.org/users/dr%20mt%20niknejadhttp://radiopaedia.org/users/dr%20mt%20niknejadhttp://radiopaedia.org/articles/rheumatoid-arthritishttp://radiopaedia.org/articles/rheumatoid-arthritishttp://radiopaedia.org/articles/rheumatoid-arthritishttp://books.google.com/books?vid=ISBN007174889Xhttp://books.google.com/books?vid=ISBN007174889Xhttp://books.google.com/books?vid=ISBN007174889Xhttp://www.amazon.com/gp/product/007174889X?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=007174889Xhttp://www.amazon.com/gp/product/007174889X?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=007174889Xhttp://books.google.com/books?vid=ISBN0323040683http://books.google.com/books?vid=ISBN0323040683http://books.google.com/books?vid=ISBN0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://www.amazon.com/gp/product/0323040683?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0323040683http://books.google.com/books?vid=ISBN0323040683http://www.amazon.com/gp/product/007174889X?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=007174889Xhttp://books.google.com/books?vid=ISBN007174889Xhttp://radiopaedia.org/articles/rheumatoid-arthritishttp://radiopaedia.org/users/dr%20mt%20niknejad
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