Imaging Case of the Week 113

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?


CT chest axialCT chest coronalCt chest sagittal

[peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”]


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.

The split pleura sign

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

Inverted D sign


Here is a great article on signs in thoracic imaging: