When imaging a child with suspected acute epiglottitis, what sign would you expect to see on a lateral neck x-ray?

In the context of imaging a child with suspected acute epiglottitis, the thumb sign is particularly significant. This sign is characterized by the enlarged and swollen appearance of the epiglottis on a lateral neck x-ray. The swollen epiglottis resembles a thumb, which is where the name originates. Recognition of the thumb sign is crucial as it indicates inflammation and potential obstruction of the airway, requiring urgent medical attention.

The steeple sign, while it appears in cases of croup due to subglottic narrowing, is not associated with epiglottitis. The hourglass sign and claw sign are also not relevant in this context and do not typically appear in cases involving epiglottitis. In summary, identifying the thumb sign on a lateral neck x-ray is an essential factor in diagnosing acute epiglottitis, underscoring the importance of accurate imaging in assessing respiratory conditions in children.