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On lateral C-spine X-ray, the thumbprint sign describes a swollen, enlarged epiglottis. [10] A normal X-ray, however, does not exclude the diagnosis. [10] An ultrasound may be helpful if specific changes are present, but its use (as of 2018) is in the early stages of study. [10] On CT imaging, the "Halloween sign" describes an epiglottis of ...
Croup is typically diagnosed based on signs and symptoms after potentially more severe causes, such as epiglottitis or an airway foreign body, have been ruled out. [4] Further investigations, such as blood tests, X-rays and cultures, are usually not needed. [4] Many cases of croup are preventable by immunization for influenza and diphtheria. [5]
[1] [2] The presence of the steeple sign supports a diagnosis of croup, usually caused by paramyxoviruses. [3] It can also be defined as the replacement of the usual squared-shoulder appearance of the subglottic area by cone-shaped narrowing just distal to the vocal cords. This is called the steeple or pencil-point sign.
In radiology, the thumbprint sign, or thumbprinting, is a radiologic sign found on a radiograph that suggests the diagnosis of either epiglottitis or intestinal ischemia.. In a lateral C-spine radiograph, the sign is caused by a thickened free edge of the epiglottis, which causes it to appear more radiopaque than normal, resembling the distal thumb.
X-ray findings may include subglottic narrowing. The priority is to secure the patient's airway, and to rule out croup and epiglottitis which may be fatal. Suspicion for tracheitis should be high in cases of onset of airway obstruction that do not respond to racemic epinephrine.
Croup (Laryngotracheobronchitis) is a viral infection of the vocal cords typically lasting five to six days. The main symptom is a barking cough and low-grade fever. On an X-ray, croup can be recognized by the "steeple sign", which is a narrowing of the trachea. It most commonly occurs in winter months in children between the ages of 3 months ...
The swollen throat is often accompanied by a serious respiratory condition, characterized by a brassy or "barking" cough, stridor, hoarseness, and difficulty breathing; and historically referred to variously as "diphtheritic croup," [13] "true croup," [14] [15] or sometimes simply as "croup."
Inspiratory stridor often occurs in children with croup. It may be indicative of serious airway obstruction from severe conditions such as epiglottitis, a foreign body lodged in the airway, or a laryngeal tumor. Stridor should always command attention to establish its cause.