Question:easy
The image shows bluish-purple discolouration behind the mastoid. Identify the sign.
The image shows bluish-purple discolouration behind the mastoid. Identify the sign.
Show Hint
Mastoid ecchymosis after head injury has a single eponymous name suggesting a base-of-skull fracture.
Updated On: Jun 23, 2026
- Battle sign
- Bezold abscess
- Both A and B
- None of these
Show Solution
The Correct Option is A
Solution and Explanation
Match the colour and the spot. Purple bruising sitting over the mastoid prominence behind the ear is the Battle sign, a soft-tissue marker that a basilar (middle fossa or petrous) skull fracture has bled into the mastoid region.
Distinguish the distractor: a Bezold abscess is not a bruise at all. It is pus tracking from the mastoid tip into the upper neck along the sternocleidomastoid in advanced mastoiditis, felt as a firm tender neck mass, so it cannot be what a retroauricular ecchymosis shows.
Because the image is purely retroauricular discolouration, the only correct label is Battle sign (option A); Both A and B and None are therefore wrong. Battle sign often appears a day or more after the injury, alongside raccoon eyes, CSF rhinorrhoea or otorrhoea in basal skull fracture. Ref: StatPearls, Battle sign.
Distinguish the distractor: a Bezold abscess is not a bruise at all. It is pus tracking from the mastoid tip into the upper neck along the sternocleidomastoid in advanced mastoiditis, felt as a firm tender neck mass, so it cannot be what a retroauricular ecchymosis shows.
Because the image is purely retroauricular discolouration, the only correct label is Battle sign (option A); Both A and B and None are therefore wrong. Battle sign often appears a day or more after the injury, alongside raccoon eyes, CSF rhinorrhoea or otorrhoea in basal skull fracture. Ref: StatPearls, Battle sign.
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