E1261. Farm to Table: Classic Animal- and Food-Related Imaging Signs in Musculoskeletal Radiology
  1. Paul Wojack; Zucker School of Medicine at Hofstra/Northwell
  2. Jonathan Sterman; Montefiore Nyack Hospital
  3. Katherine Chung; Stony Brook University Hopsital
  4. Edward Mardakhaev; Montefiore Medical Center
The descriptive language of radiology utilizes a wide vocabulary of imaging signs to succinctly characterize imaging findings and guide the radiologist to the correct diagnosis. These characteristic signs are incredibly diverse, with food and animals being some of the most commonly evoked imagery. A large number of common pathologies have been assigned one or more of these signs, from food-related signs such as the “pancake” vertebra, “sausage” digit, and the “neapolitan” or “parfait” sign seen with lipohemarthrosis, to animal-related signs such as the “pooping duck” sign of triquetral fractures and the “rat bites” of gout. This wide palette of imaging signs enables the radiologist to quickly recognize certain patterns of pathology and, in many cases, these signs may be pathognomonic for a specific pathologic process. Knowledge of these classic signs is critical to enable the radiologist to review patterns of pathology quickly and accurately.

Educational Goals / Teaching Points
A variety of musculoskeletal imaging signs will be reviewed, with an emphasis on both animal- and food-related signs. While it is impossible to cover every imaging sign in a single exhibit, emphasis will be placed on common and notewortSpecific examples are listed below.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Featured signs encompass a wide range of traumatic, degenerative, and infectious conditions. These include, but are not limited to food-related signs including pancake vertebrae - advanced compression deformity (vertebra plana), sandwich vertebrae - osteopetrosis, neapolitan or parfait sign - lipohemarthrosis, sausage digit - dactylitis and certain arthropathies, rice bodies - rheumatoid arthritis and other arthropathies, celery stalk sign - mucoid degeneration of the anterior cruciate ligament, celery stalk metaphysis - congenital infections of the metaphyses and osteopathia striata, spilled teacup sign - lunate dislocation, onion skin periosteal reaction - osteosarcoma, Ewing sarcoma, osteomyelitis, and reverse hamburger bun sign - facet dislocation (locked facet). Animal-related signs include rat bite erosions - gout, gull wing erosions - erosive osteoarthritis, swan neck deformity - rheumatoid arthritis, pooping duck sign - triquetral fracture, fishtail deformity - humeral osteonecrosis, winking owl sign - spinal pedicular destruction, butterfly vertebrae - congenital spinal fusion anomalies, butterfly fragment - comminuted long bone fractures, and anteater nose sign - tarsal coalition.

Vividly-named radiological signs are present throughout radiology, and musculoskeletal imaging is no exception. Through the carefully selected “farm to table” signs presented above, the reader will learn about the appearance of a wide array of traumatic, degenerative, and infectious conditions and be able to readily recognize these conditions in their future practice.