Classic radiologic signs an atlas and history PDF
Preview Classic radiologic signs an atlas and history
CLASSIC RADIOLOGIC SIGNS CLASSIC RADIOLOGIC SIGNS An atlas and history MICHAEL E. MULLIGAN Assistant Professor, Diagnostic Radiology, University of Maryland, School of Medicine 0 CRC Press cflJ Taylor & F rancis G roup Boca Ratan London New Y ork CRC Press is an imprint o f t he Taylor & Francis Group, an informa b usiness CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 1997 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original V.S. Government works This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity ofall materials or the consequences of their use. 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Visit the Tayior & Francis Web site at http://www.tayiorandfrancis.com and the CRe Press Web site at http://www.crcpress.com DEDICATION This book is dedicated to all radiologists and their fanciful imaginations, especially to Wilhelm Conrad Rontgen who made it all possible v TABLE OF CONTENTS Preface lX Greenstick fracture 70 Acknowledgement Ground glass pattern 72 Gull wings and mouse ears 74 Apple core (napkin ring) lesion 2 Hair-on-end pattern 76 Asterisk sign 4 Hitch-hiker's thumb 78 Bamboo spine 6 Hockey stick (fishhook, J-shaped) ureter 80 Beak (claw) sign 8 Honda ('H') sign 82 Beaten silver (beaten brass) pattern 10 Honeycomb lung 84 Blade of grass (flame or 'V') sign 12 Horseshoe kidney 86 Boot-shaped heart (coeur en sabot) 14 Iceberg (tip of the iceberg) sign 88 Bowler hat sign 16 Ivory vertebra 90 Bullet shaped (bullet-nose) vertebrae 18 Lead (gas) pipe sign 92 Butterfly and bat's wing shadow 20 Lemon and banana signs 94 Leontiasis ossea 96 Button sequestrum 22 Lincoln log (H-shaped) vertebra 98 Camalote (waterlily) sign 24 Linguine (free-floating loose thread) sign 100 Carpenter's level sign 26 Mallet (baseball) finger 102 Celery-stick (celery stalk) metaphysis 28 Marble bone 104 Cloverleaf skull 30 Mercedes-Benz (Mercedes star) sign 106 Cobblestone pattern 32 Mickey Mouse sign 108 Cobra head (snake head) ureter 34 Miliary pattern 110 Codfish (fish) vertebra 36 Mogul shadow 112 Codrnan triangle (Codman angle) 38 Moth-eaten pattern 114 Coffee bean sign 40 Napoleon hat (bow) sign 116 Coin lesion 42 Onion skin sign 118 Cookie bite (cookie cutter) lesions 44 Parchment heart 120 Corduroy cloth vertebra 46 Phrygian cap gallbladder 122 Cotton wool sign 48 Picket-fence and stack of coins signs 124 Crescent sign 50 Picture frame sign 126 Cupid's bow vertebra 52 Pine tree (Christmas tree) bladder 128 Delta (empty triangle) sign 54 Playboy bunny sign 130 Doughnut sign 56 Porcelain gallbladder 132 Dripping candlewax sign 58 Pruned tree and leafless tree signs 134 Dromedary kidney 60 Ribbon (twisted-ribbon) ribs 136 Egg shaped (egg-on-a-string) heart 62 Rugger-jersey spine 138 Egg-shell calcifications 64 'S' (Golden's) sign 140 Erleruneyer flask deformity 66 Saber-sheath trachea 142 Football sign 68 Sabre shin 144 vii Classic Radiologic Signs Sail and spinnaker sail signs 146 Sausage (cocktail sausage) digit 148 Scimitar sign 150 Scottie dog sign 152 Shepherd's crook 154 Shmoo shaped heart 156 Shotgun (parallel channel) sign 158 Silhouette sign 160 Silver fork deformity 162 Snowman (figure-8) sign 164 Spinning top (arrowhead) urethra 166 Staghorn calculi 168 String sign 170 Sunburst pattern 172 Tear-drop (pear-shaped) bladder 174 Telephone receiver femur 176 Terry-Thomas and signet ring signs 178 Thumbprinting sign 180 Tram-line (railroad track) sign 182 Turret exostosis 184 Waterfall hilum 186 Wine goblet (wine glass) sign 188 VIII PREFACE Radiology is a visual art. Since the discovery of the of importance to medicine and to the sick. X-ray in 1895. many of the radiographic patterns the physician who convinces his colleagues we see have been given catchy descriptive names of the value of a new procedure. which they that are supposed to help us remember and then adopt. exceeds in significance his recognize certain disease patterns or entities. A few hapless fellow who devised the same textbooks have been written that catalog more than procedure earlier but failed to gain its 400 of these terms. In honor of the 100th adoption. And by the same token. the anniversary of Rontgen's discovery of the X-ray. individual who first clearly establishes the this book will illustrate and elaborate on the history nature of a condition is usually more of 100 of the more classic (or soon to be classic) deserving of the eponym than the forgotten radiologic signs. If we are to be able to use these author of a mere description unearthed by terms with full understanding. we must visualize diligent scholasticism or pure serendipity. the object depicted by the term. imagine its radi ographic appearance and transfer that picture to With diligent scholasticism and some serendipity. I the radiographic image before us. This book is have carefully tried to track down the first use or intended to help all students and practitioners of first appearance in print of these terms or their our art accomplish that task. antecedents. The original articles and books were used whenever they were available to me. There is The following sentiments. expressed by Mark no doubt that some terms were in use long before Ravitch'. regarding eponyms apply equally well to their 'documentation' in the literature. Any errors many of the terms to be described in this book: or misappropriations are my own and I accept full My own feeling is that whatever their responsibility for them. I did not try to document fallibiliry. eponyms illuminate the lineage of the first description of each disease entity. That surgery and bring to it the color of old would have doubled my chances of being wrong. times. distinguished figures. ancient sieges. Other books dealing with the history of medicine and pestilences. and continually remind us have compiled that type of information. For those of the international nature of science. ofyou who would quarrel with my assertions about who reported what. please keep in mind the Fallible eponyms certainly may be. maxims of Mark Ravitch" quoted above. Given an eponym one may be sure (1) that the man so honored was not the first to Many of the terms described in this book have describe the disease. the operation. or the been used for more than one abnormality over the instrument. or (2) that he misunderstood last 100 years. I have described in detail only one the situation. or (3) that he is generally usage of the term that I considered most appro misquoted. or (4) that (1). (2). and (3) are priate for this book. Some people will not agree all simultaneously true ... that the terms I have selected are the most classic. Priority. in the award of an eponym. is Others will be disappointed when they do not find not necessarily purely temporal: ... in terms their favorite sign in the book. In reply, I would say ix
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