Question:easy
Steeple sign, seen in the image below, is seen in which of the following conditions?
Steeple sign, seen in the image below, is seen in which of the following conditions?
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A pencil-tip narrowing of the subglottic trachea goes with a barking cough.
Updated On: Jun 23, 2026
- Acute epiglottitis
- Acute laryngotracheobronchitis
- Laryngeal papillomatosis
- Bilateral abductor paralysis
Show Solution
The Correct Option is B
Solution and Explanation
Sign to disease: Steeple sign equals croup, that is acute laryngotracheobronchitis.
On a front-on neck X-ray the air column in the subglottis normally has shoulders; in croup the mucosa swells and the air column tapers smoothly to a point, exactly like the spire of a church steeple (also called the wine-bottle or pencil-tip sign). Croup is usually viral, hits toddlers under 2, comes on gradually, and produces biphasic stridor, hoarseness, and a barking cough.
Contrast trick: Do not confuse it with the thumbprint sign of acute epiglottitis, which is a swollen epiglottis on a lateral film and is a more sudden, toxic, drooling illness. Laryngeal papillomatosis would show nodular soft-tissue shadows, and bilateral abductor paralysis is diagnosed by laryngoscopy, neither giving a steeple.
Ref: Bailey and Love, 27th edition.
On a front-on neck X-ray the air column in the subglottis normally has shoulders; in croup the mucosa swells and the air column tapers smoothly to a point, exactly like the spire of a church steeple (also called the wine-bottle or pencil-tip sign). Croup is usually viral, hits toddlers under 2, comes on gradually, and produces biphasic stridor, hoarseness, and a barking cough.
Contrast trick: Do not confuse it with the thumbprint sign of acute epiglottitis, which is a swollen epiglottis on a lateral film and is a more sudden, toxic, drooling illness. Laryngeal papillomatosis would show nodular soft-tissue shadows, and bilateral abductor paralysis is diagnosed by laryngoscopy, neither giving a steeple.
Ref: Bailey and Love, 27th edition.
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