Which radiographic sign is NOT associated with epiglottitis?

• A. Thumbprint sign
• B. Steeple sign
• C. Kernig's sign
• D. Cullen's sign

Answer: (B)

In pediatric airway imaging, epiglottitis and croup show different radiographic patterns. Epiglottitis typically presents with the thumbprint sign on a lateral neck view, caused by a swollen, enlarged epiglottis. The steeple sign, seen as subglottic narrowing on an anteroposterior neck radiograph, is characteristic of croup, not epiglottitis. Cullen's sign and Kernig's sign are not radiographic airway findings at all (Cullen's sign is abdominal ecchymosis; Kernig's sign is a meningeal irritation sign). Therefore, the radiographic sign not associated with epiglottitis is the steeple sign, since it points to croup rather than epiglottitis.