Abdominal and GI imaging: Chilaiditi sign: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: Chilaiditi sign

Sample item

An asymptomatic elderly man's erect chest film shows a lucency under the right hemidiaphragm. Haustral folds can be seen within it, and it is unchanged on decubitus views. What is the explanation?

AAir in a ruptured hydatid cystBFree intraperitoneal air from perforationCGas-containing subphrenic abscessDColon interposed between liver and diaphragm

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Colon interposed between liver and diaphragm

Chilaiditi sign is hepatodiaphragmatic interposition of bowel, usually colon, and is a benign finding in the absence of symptoms. Haustra and an unchanged position on decubitus films separate it from pneumoperitoneum.

Option by option

A. Air in a ruptured hydatid cyst
A ruptured hydatid cyst occurs inside the liver and gives the water lily or double arc sign.
B. Free intraperitoneal air from perforation
Free air does not show haustra and shifts with posture.
C. Gas-containing subphrenic abscess
An abscess is symptomatic with fever and has a fluid level or mass effect.
D. Colon interposed between liver and diaphragm (correct)
Correct. Haustral folds and a fixed position mean bowel sits under the diaphragm.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Colon interposed between liver and diaphragm. Chilaiditi sign is hepatodiaphragmatic interposition of bowel, usually colon, and is a benign finding in the absence of symptoms.

Why is "Air in a ruptured hydatid cyst" not the answer?

A ruptured hydatid cyst occurs inside the liver and gives the water lily or double arc sign.

Why is "Free intraperitoneal air from perforation" not the answer?

Free air does not show haustra and shifts with posture.

Why is "Gas-containing subphrenic abscess" not the answer?

An abscess is symptomatic with fever and has a fluid level or mass effect.

What concept does this question test?

It tests Abdominal and GI imaging: Chilaiditi sign in Radiology. Haustra and an unchanged position on decubitus films separate it from pneumoperitoneum.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: Chilaiditi sign?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.