The lateral neck x-ray shows features of epiglottitis with a positive thumb print & vallecula sign.

Thumb print sign is due to a swollen epiglottis and vallecula sign is due to obliteration of the deep vallecular air pocket by the swollen epiglottis.

The above patient was managed with intravenous antibiotics and steroids in a high dependency unit and got better.

How sensitive is lateral neck x-ray in diagnosing epiglottitis? One study shows moderate diagnostic accuracy only. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667265/