Which sign on imaging indicates epiglottitis?

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

Answer: (D)

The imaging finding for epiglottitis is the thumbprint sign. On a lateral neck X-ray, the epiglottis becomes markedly swollen and thickened, producing a rounded shadow that protrudes into the airway much like a human thumbprint. This appearance signals acute epiglottitis, a condition that can rapidly compromise the airway and requires swift airway assessment and appropriate treatment.

The steeple sign is associated with subglottic narrowing seen in viral croup, not epiglottitis. Kernig's sign and Cullen's sign are unrelated clinical findings (m meningitis or intra-abdominal bleeding, respectively) and do not describe airway imaging.