Thumbprint sign

Medical condition

Thumbprint sign

Lateral radiograph showing the "thumb sign". The diagnosis of epiglottitis was confirmed on subsequent imaging and laryngoscopy. The patient recovered following treatment with prednisone and ceftriaxone
Differential diagnosis	epiglottitis or intestinal ischemia

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.

In an abdominal radiography, thumbprinting has an appearance of thumbs protruding into the intestinal lumen, and is caused by thickened edematous mucosal folds.^[1] Abdominal thumbprinting is a non-specific finding, though one potential cause is intestinal ischemia.^[2]

References

^ Page 111 in:Elizabeth D Agabegi; Agabegi, Steven S. (2008). Step-Up to Medicine (Step-Up Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-0-7817-7153-5.
^ Acute epiglottitis at eMedicine

External links

Thumbprint sign on plain film

Diseases of the respiratory system

Upper RT
(including URTIs,
common cold)

Head	sinuses Sinusitis nose Rhinitis Vasomotor rhinitis Atrophic rhinitis Hay fever Nasal polyp Rhinorrhea nasal septum Nasal septum deviation Nasal septum perforation Nasal septal hematoma tonsil Tonsillitis Adenoid hypertrophy Peritonsillar abscess
Neck	pharynx Pharyngitis Strep throat Laryngopharyngeal reflux (LPR) Retropharyngeal abscess larynx Croup Laryngomalacia Laryngeal cyst Laryngitis Laryngopharyngeal reflux (LPR) Laryngospasm vocal cords Laryngopharyngeal reflux (LPR) Vocal fold nodule Vocal fold paresis Vocal cord dysfunction epiglottis Epiglottitis trachea Tracheitis Laryngotracheal stenosis

Lower RT/
lung disease
(including LRTIs)

Bronchial/
obstructive

acute: Acute bronchitis

chronic

COPD

Chronic bronchitis

Acute exacerbation of COPD)

Asthma (Status asthmaticus

unspecified

Bronchiolitis obliterans

Diffuse panbronchiolitis

Interstitial/
restrictive
(fibrosis)

External agents/ occupational lung disease	Pneumoconiosis Aluminosis Asbestosis Baritosis Bauxite fibrosis Berylliosis Caplan's syndrome Chalicosis Coalworker's pneumoconiosis Siderosis Silicosis Talcosis Byssinosis Hypersensitivity pneumonitis Bagassosis Bird fancier's lung Farmer's lung Lycoperdonosis
Other	ARDS Combined pulmonary fibrosis and emphysema Pulmonary edema Löffler's syndrome/Eosinophilic pneumonia Respiratory hypersensitivity Allergic bronchopulmonary aspergillosis Hamman–Rich syndrome Idiopathic pulmonary fibrosis Sarcoidosis Vaping-associated pulmonary injury

Obstructive /
Restrictive

Pneumonia/
pneumonitis

By pathogen	Viral Bacterial Pneumococcal Klebsiella Atypical bacterial Mycoplasma Legionnaires' disease Chlamydiae Fungal Pneumocystis Parasitic noninfectious Chemical/Mendelson's syndrome Aspiration/Lipid
By vector/route	Community-acquired Healthcare-associated Hospital-acquired
By distribution	Broncho- Lobar
IIP	UIP DIP BOOP-COP NSIP RB

Other

Atelectasis
circulatory
- Pulmonary hypertension
- Pulmonary embolism
Lung abscess

Pleural cavity/
mediastinum

Pleural disease	Pleuritis/pleurisy Pneumothorax/Hemopneumothorax Pleural effusion Hemothorax Hydrothorax Chylothorax Empyema/pyothorax Malignant Fibrothorax
Mediastinal disease	Mediastinitis Mediastinal emphysema

Other/general

v t e Radiologic signs
Cardiovascular	Aortic unfolding Dense artery sign Halo sign
Respiratory	Air crescent sign Deep sulcus sign Golden S sign Hampton hump Kerley lines Peribronchial cuffing Sail sign of the chest Silhouette sign Steeple sign Thumbprint sign Traction bronchiectasis Tree-in-bud sign Westermark sign
Urogenital	Canga's bead symptom
Musculoskeletal	Crescent sign Fabella sign Fat pad sign/Sail sign of the elbow Osteopathia striata
Gastrointestinal	Cupola sign Double bubble Endoexoenteric Football sign Hampton's line Hot quadrate sign Mumoli's sign Omental cake Pneumatosis intestinalis Rigler's sign Sentinel loop
Neurological	Hyperdense middle cerebral artery