Thursday, 2 January 2014


AQUINO'S SIGN is the blanching of the tympanic mass with gentle pressure on the carotid artery.Seen in Glomus tumors .

BATTLE SIGN - Bruising behind ear at mastoid region, due to petrous temporal bone fracture (middle
fossa #)
Inflammatory edema at the tip of the mastoid process in mastoiditis

BOCCA’S SIGN - Absence of post cricoid crackle(Muir’s crackle) in Ca post cricoid

Refers to the blanching noted when applying positive pressure {with Siege's speculum } to the tympanic membrane of a patient with Glomus tumor .

BRYCE SIGN - If combined laryngocele & external laryngocele is presenting as a neck mass,  compression will cause a hissing sound as the air escapes from it into the larynx. This test is fraught with danger in cases of combined laryngoceles because air from the external component may get forced into the internal component causing acute airway obstruction.

Lateral sinus thrombosis on CT or MRI with contrast shows an empty triangle appearance of the
thrombosed sinus surrounded by contrast enhanced dura{since contrast may flow around the clot
to outline the periphery of the sinus}. It is also called as empty triangle sign.

X-ray finding-Crescent of air between the mass and posterior pharyngeal wall. positive in AC ployp
Negative in Angiofibroma

FURSTENBERG'S SIGN- Positive in Encephaloceles .Owing to the intracranial connection, there is
pulsation and expansion of the mass with crying, straining, or compression of the jugular vein (Furstenberg test).This is used to differentiate Nasal Encephaloceles from other congenital midline nasal masses like Nasal Gliomas.

GRIESINGER'S SIGN -Erythema and oedema posterior to the mastoid process resulting from septic
thrombosis of the mastoid emissary vein. seen in lateral sinus thrombosis

- A finding in CSF rhinorrhea when CSF is mixed with Blood. In patients with head trauma, a mixture of
blood and CSF may make the diagnosis difficult. CSF separates from blood when it is placed on filter paper, and it produces a clinically detectable sign: the ring sign, double-ring sign, or halo sign. CSF will separate from blood when the mixture is placed on filter paper resulting in a central area of blood with an outer ring or halo. Blood alone does not produce a ring. The best ring is obtained with a 50: 50 mix of blood and CSF.
More importantly, they found that the presence of a ring was not exclusive for CSF. Blood mixed with tap
water, saline, and rhinorrhea fluid also produced a ring. The halo sign does occur, but clearly does not clinch the diagnosis.

HITSELBERGER’S SIGN - In Acoustic neuroma- loss of sensation in the postero-superior part of external auditory meatus supplied by Arnold’s nerve( branch of Vagus nerve to ear )

The anterior bowing of the posterior wall of the antrum seen on lateral skull film . Pathognomic for juvenile nasopharyngeal angiofibroma .

HONDOUSA SIGN –X-ray finding in Angiofibroma . indicating infratemporal fossa involvement characterised by widening of gap between ramus of mandible and maxillary body. 

It is a false positive fistula test when there is no evidence of middle ear disease causing fistula of horizontal semicircular canal. It is seen in 25% cases of meniere's disease or congenital syphilis.In 25% cases of Meneire’s ,fibrous bands form connecting utricular macule to stapes footplate. In syphilis due to hypermobile stapes
footplate.[ Hennebert sign - pressure induced nystagmus , Hennebert symptom - pressure induced dizziness]

positive squeeze test in chronic tonsillitis.

LAUGIER'S SIGN -Blood behind the eardrum suggests basilar skull fracture .

LEUDET'S SIGN -Inflammation of the eustachian tube can produce a bright clicking sound heard by the
examiner through the otoscope while the patient experiences it as tinnitus.caused by reflex spasm of
the tensor palati muscle.

LIGHT HOUSE SIGN —A small pin
hole perforation with a pulsatile
ear discharge is seen in Acute
suppurative otitis media.
LYRE’S SIGN - splaying of carotid
vessels( at junction of External &
internal carotid artery) in carotid
body tumor .
MILIAN’S EAR SIGN - Erysipelas
can spread to pinna(cuticular
affection), where as cellulitis
Cellulitis and erysipelas manifest
as areas of skin erythema, edema
and warmth in the absence of
underlying suppurative foci.
They differ in that erysipelas
involves the upper dermis and
superficial lymphatics, whereas
cellulitis involves the deeper
dermis and subcutaneous fat.
As a result, erysipelas has more
distinctive anatomic features than
cellulitis; erysipelas lesions are
raised above the level of
surrounding skin, and there is a
clear line of demarcation between
involved and uninvolved tissue.
Classic descriptions of erysipelas
note "butterfly" involvement of the
Involvement of the ear (Milian's
ear sign) is a distinguishing
feature for erysipelas since this
region does not contain deeper
dermis tissue.
Paul Dudley White's winking ear
lobe sign-Movement of the ear
lobe coincident with the pulse
suggests tricuspid insufficiency.
PHELP’S SIGN - loss of crest of
bone (as seen in CT-scan) between
carotid canal and jugular canal in
glomus jugulare .
RAT TAIL SIGN /“Bird-beak” sign -
Sign in barium swallow of
achalasia. The oesophagus is
dilated, and contrast material
passes slowly into the stomach as
the sphincter opens intermittently.
The distal oesophagus has a
narrow segment and the image
resembles a bird's beak.
This is in contrast to the rat's tail
appearance of carcinoma of
oesophagus.Barium swallow shows
characteristic rat tail appearance
with irregular mucosa margins in
carcinoma esophagus .
There is red vascular hue seen
behind the intact tympanic
membrane. it is seen in glomus
tumour, high jugular bulb and
aberant carotid artery in the
floor of middle ear .
RACCOON SIGN -Indicate subgaleal
hemorrhage,and not necessarly
base of skull .
It is also called flamingo flush
sign. it is seen because of
increased vascularity in submucous
layer of promontory in active phase
of otosclerosis(otospongiosis).
STEEPLE SIGN- X-ray finding in
Acute laryngotracheobronchitis
(CROUP).The steeple sign is
produced by the presence of
edema in the trachea, which
results in elevation of the tracheal
mucosa and loss of the normal
shouldering (lateral convexities) of
the air column.
orbital injury during FESS . fat
protrude in to nasal cavity on
compression of eye ball from
outside .
Seen in Orbital floor fracture . It
is defined as tear drop shaped
opacification seen hanging from
the roof of the maxillary sinus on
water's view. The floor of the orbit
is the most common portion of the
orbit to sustain fracture. A classic
radiographic finding in blow-out
fractures is the presence of a
polypoid mass (the tear-drop)
protruding from the floor of the
orbit into the maxillary antrum
The tear-drop represents the
herniated orbital contents,
periorbital fat and inferior rectus
It is a thumb like impression (due
to enlarged epiglottis) seen on X-
ray lateral view neck in patients
with acute epiglottitis.Direct
visualization of the epiglottis by
laryngoscope, if attempted, reveals
a beefy red, edematous epiglottis.
In acute otitis externa there is
marked tenderness when tragus is
pressed against the pinna.
TEA POT SIGN is seen in CSF
rhinorrhoea .This could be related
to the relationship of the sphenoid
ostium to the sinus floor. The
sphenoid ostium lies at an
appreciable distance anterosupe-
rior from the sinus floor. An
increase in the CSF rhinorrhea
therefore occurs in a case of
sphenoid sinus leak when the
patient bends forward as an
increasing amount of CSF gains
access to the ostium "teapot" sign.
uvula pointing sign - uvula points
to side of palatal palsy
Uvula pointing sign - seen in
rhinoscleroma .when scleroma
involve nasopharynx ,uvula point
towards roof of nasopharynx.
WOODS SIGN —– palpable
jugulodigastric lymphnodes

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