Named Radiologic Signs by Lung Region

Lung Region Named Radiologic Sign Associated Condition / Meaning
Upper Lung Luftsichel Sign Collapse of the LUL, crescent of hyperlucency due to hyperexpanded superior segment of LLL
Golden S Sign RUL collapse with central mass (e.g., bronchogenic carcinoma) causing reverse-S-shaped fissure
Air Crescent Sign Aspergilloma or cavitary retraction from healing infection (e.g., TB)
Hollowed Cavity Sign Cavitating lesion (often TB or fungal) in upper lobes
Mid Lung Hilum Overlay Sign Distinguishes anterior or posterior mediastinal masses from hilar enlargement
Double Density Sign Left atrial enlargement seen as double contour along right heart border
Batwing Pattern Alveolar edema due to CHF — bilateral perihilar opacities sparing the periphery
Split Pleura Sign Empyema — thickened, enhancing parietal and visceral pleura separated by fluid
Sandwich Sign Pericardial effusion seen between fat pads on lateral CXR
Lower Lung Deep Sulcus Sign Pneumothorax on supine CXR — deepened costophrenic angle on affected side
Juxtaphrenic Peak Sign Volume loss (esp. LUL collapse) causes peak at medial diaphragm insertion
Shaggy Heart Border Loss of clear heart border due to adjacent lower lobe infiltrates or ILD
Meniscus Sign Blunting of costophrenic angle due to pleural effusion (also called Ellis curve)
Rounded Atelectasis Sign Comet tail sign + mass-like pleural-based opacity often in posterior lower lobes (e.g., asbestos)

Notes

  • Some signs (e.g., air bronchogram, crazy paving) are diffuse and not zone-specific.

  • Distribution here is based on typical presentations; pathology may vary.

  • Signs such as the “finger-in-glove” (ABPA) or “tree-in-bud” (infection/bronchiolitis) appear peribronchially and often span multiple zones.