The following CT images are from a 40 year old with high fever, cough and dyspnoea. What two radiological signs, belonging to the same condition, can you observe in the images?

 

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The above CT images are from a patient with empyema. The two radiological signs are:

1. The Split Pleura sign: separation of the pleural layers by fluid and enhancement of the visceral and parietal pleura on a contrast enhanced CT.

2. An inverted D sign on a sagittal chest CT or a lateral chest x-ray strongly suggests an encapsulated empyema.

 

Here is a great article on signs in thoracic imaging:

http://seicat.org/repo/static/public/documentos/top10-toracica/Signs_in_Thoracic_Imaging

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