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Classic Radiologic Signs

An Atlas and History

University of South Alabama, Mobile, AL 36617-2293

By Michael E. Mulligan. New York: Parthenon, 198 pp., 1997. $49.95

If you would like to review books for AJR, please send a cover letter stating your interest with a current curriculum vitae to Assistant Editor for Book Reviews, AJR, 101 S. Stratford Rd., Ste. 303, Winston-Salem, NC 27104.

Despite this rather bland title, Dr. Mulligan serves up a delicious stew here, mixing education and entertainment in good proportion, seasoned with solid scholarship and garnished with dollops of whimsey. Beyond an alphabetic arrangement of included signs, there is no attempt at an encyclopedic scope. Rather, the author pegs this effort to the radiology centennial as an excuse for limiting this volume to 100 signs with catchy descriptive names. Further, he makes no bones about the fact that the 100 choices are his alone; thus, one should not be surprised that almost half of the signs selected relate to the musculoskeletal system. However, the primary allocation selected for some signs with multiple system usage will startle the reader on occasion (e.g., tram tracks in aspergillosis rather than ankylosing spondylitis). His list of 100 best signs of the century doesn't always coincide with mine (why choose cupid's bow vertebra over bow-tie vertebra, or the extremely rare parchment heart instead of the panzerherz [armored heart] of calcific pericarditis?). I would certainly have included juvenile osteopetrosis as another, more sharply defined, example of rugger jersey pattern than the earlier proposed hyperparathyroidism. Still, it's Mulligan's stew, and he should get to select the ingredients. Part of the fun of perusing his effort is the mental arguments one has with him and his selection process.

The limitation of signs to 100 does not limit the appeal of this volume. It offers a great deal to the amateur historian, whether general or medical. For the mature radiologist, it is a charming stroll down memory lane, greeting old friends who coined those fanciful names and recalling when one first used the sign. For the young radiologist, it offers an appreciation of his or her radiologic forebears. For the middle group, this book may clear up mysteries and misconceptions concerning the provenance of some well-known, well-used signs.

Each sign is presented with a scholarly exposition of its origin. Although Mulligan's library research is prodigious, some names are shrouded in the mists of time. Others actually predate Röntgen and are borrowed from earlier disciplines, especially pathology. Several are quite recently proposed (e.g., the linguine sign in 1994 for intracapsular rupture of silicone breast implants).

Each sign is illustrated, often with figures from the original paper introducing the sign or the buzzword for it. There also is a photographic representation of the real-life object mimicked radiologically, accompanied by a little leçon on the thing itself. These small lessons lead us into many fields of interest—botany and horticulture (water lily sign, celery stalk sign, pruned tree sign), zoology (mouse ear sign, dromedary kidney sign, bat's wing sign), sports (football sign, mediastinal moguls), cuisine (doughnut sign, apple-core lesion, sausage digit, wine glass sign), haberdashery (bowler hat sign, corduroy cloth vertebra), and even toyland (Lincoln log vertebra, spinning top urethra).

The book is a small treasure. It is reasonably priced, partly because the paper quality is less than optimal and degrades a few illustrations; however, who really needs to see another exquisite photograph of a miliary pattern or a phrygian cap? Classic Radiologic Signs should be in every radiologist's library for both education and enjoyment. After all, reviewing only three signs a night will put you to bed happy for a month. Few books and no newsmagazine can promise that.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brogdon, B.G. Search for Related Content PubMed Articles by Brogdon, B.G. Social Bookmarking                      What's this?