Steeple Sign: A Radiologic Sign of Upper Airway Narrowing
What is the Steeple Sign?
The steeple sign is a radiologic sign that is seen on a frontal neck radiograph (an X-ray of the neck taken from the front). It is characterized by subglottic tracheal narrowing, which produces the shape of a church steeple within the trachea.
Other Names for the Steeple Sign
The steeple sign is also known as the wine bottle sign and the inverted V sign.
Causes of the Steeple Sign
The most common cause of the steeple sign is croup, a respiratory infection that causes swelling and narrowing of the upper airway.
Other causes of the steeple sign include:
- Epiglottitis
- Tracheal stenosis
- Tracheal tumors
- Foreign bodies in the airway
- Trauma to the neck
Clinical Significance of the Steeple Sign
The steeple sign can indicate that a child has croup, a serious respiratory infection that can cause breathing difficulties.
If you see the steeple sign on a neck radiograph, it is important to seek medical attention immediately.
How is the Steeple Sign Diagnosed?
The steeple sign is diagnosed by a doctor by examining a frontal neck radiograph.
Treatment for the Steeple Sign
The treatment for the steeple sign depends on the cause of the narrowing of the upper airway.
If the steeple sign is caused by croup, treatment may include:
- Cool mist humidification
- Saline nasal drops
- Oral or inhaled corticosteroids
- Bronchodilators
If the steeple sign is caused by epiglottitis, treatment may include:
- Intubation
- Tracheostomy
Prognosis for the Steeple Sign
The prognosis for the steeple sign depends on the underlying cause of the narrowing of the upper airway.
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