Which radiographic sign on lateral neck X-ray suggests epiglottitis?

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Multiple Choice

Which radiographic sign on lateral neck X-ray suggests epiglottitis?

Epiglottitis classically causes swelling of the epiglottis and surrounding supraglottic tissues. On a lateral neck X-ray, this swelling appears as a thick, rounded shadow of the epiglottis that bulges posteriorly and resembles a thumb. This “thumb sign” is the key radiographic clue that epiglottitis is present. The steeple sign, seen on an anteroposterior neck film, reflects subglottic narrowing typical of croup, not epiglottitis. Hyperinflation on a chest X-ray points to other airway or parenchymal processes like bronchiolitis or asthma, not epiglottitis. Absence of airway swelling would not fit epiglottitis.

Epiglottitis classically causes swelling of the epiglottis and surrounding supraglottic tissues. On a lateral neck X-ray, this swelling appears as a thick, rounded shadow of the epiglottis that bulges posteriorly and resembles a thumb. This “thumb sign” is the key radiographic clue that epiglottitis is present.

The steeple sign, seen on an anteroposterior neck film, reflects subglottic narrowing typical of croup, not epiglottitis. Hyperinflation on a chest X-ray points to other airway or parenchymal processes like bronchiolitis or asthma, not epiglottitis. Absence of airway swelling would not fit epiglottitis.

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