Abdominal imaging: cupola 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 imaging: cupola sign

Sample item

A supine abdominal radiograph in a patient with peritonitis shows a lucent collection of gas overlying the lower thoracic spine, beneath the central diaphragm. What is this sign?

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

The answer and the reasoning

A. Cupola sign of pneumoperitoneum on a supine film

On a supine film, free gas collects anteriorly and may sit under the central tendon of the diaphragm and appear as an oval lucency over the lower thoracic vertebrae. An erect chest film shows free gas under the diaphragm.

Option by option

  • A. Cupola sign of pneumoperitoneum on a supine film (correct)

    Correct. Gas beneath the central diaphragm on a supine film is the cupola sign.

  • B. Hampton hump

    Hampton hump is a pleural-based opacity of infarction.

  • C. Silhouette sign

    The silhouette sign is the loss of an organ border.

  • D. Westermark sign

    Westermark sign is focal oligaemia in embolism.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Cupola sign of pneumoperitoneum on a supine film. On a supine film, free gas collects anteriorly and may sit under the central tendon of the diaphragm and appear as an oval lucency over the lower thoracic vertebrae.

Why is "Hampton hump" not the answer?

Hampton hump is a pleural-based opacity of infarction.

Why is "Silhouette sign" not the answer?

The silhouette sign is the loss of an organ border.

Why is "Westermark sign" not the answer?

Westermark sign is focal oligaemia in embolism.

What concept does this question test?

It tests Abdominal imaging: cupola sign in Radiology. An erect chest film shows free gas under the diaphragm.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 imaging: cupola 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.