Reversed S sign of Golden

The Common Vein Copyright 2008

Ashley Davidoff MD

 

(Radiology)

“is a finding that can be seen not only on posteroanterior chest radiographs, but also on computed tomographic (CT) scans (1). Because this sign resembles a reverse S shape, which the minor fissure sometimes assumes with right upper lobe collapse, it is also referred to as the “reverse S sign of Golden” (2,3). On the posteroanterior chest radiograph, the proximal or medial portion of the minor fissure is convex inferiorly, and the distal or lateral portion of the fissure is concave inferiorly (Fig 1). The analogous appearance at CT is a convex bulge along the fissural margin of a collapsed lobe (Fig 2). Although typically seen with right upper lobe collapse, the S sign can also be seen with the collapse of other lobes and has been demonstrated on the lateral chest radiograph (2,3). “