CAMRT Radiography Practice Exam

What does the steeple sign on an AP soft tissue neck x-ray indicate?

1. Epiglottitis

2. Croup

3. Tonsillitis

4. Bronchitis

The correct answer is: Croup

The steeple sign is an important radiographic finding typically seen in patients with croup, which is a common respiratory condition in children. It is characterized by a narrowing of the upper airway due to subglottic edema, and when viewed on an anterior-posterior (AP) soft tissue neck x-ray, the contour of the airway resembles a steeple or church steeple. This sign is indicative of croup, also referred to as laryngotracheobronchitis, which is caused by viral infections leading to inflammation. In contrast, conditions like epiglottitis would present with a “thumb print sign,” indicating swelling of the epiglottis, while tonsillitis typically affects the tonsils and does not present with the steeple sign. Bronchitis is more about lower airway inflammation and does not manifest as a neck x-ray finding. Therefore, the steeple sign specifically denotes the presence of croup in the right clinical context.