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German physicist Wilhelm Röntgen (1845–1923) was experimenting with electrical current when he discovered that a mysterious and invisible "ray" would pass through his flesh but leave an outline of his bones on a screen coated with a metal compound. In 1895, Röntgen made the first durable record of the internal parts of a living human: an "X-ray" image (as it came to be called) of his wife’s hand. Scientists worldwide quickly began their own experiments with...
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In anatomy, several standard anatomical positions are used as references for describing the position and orientation of different body parts. These positions help provide a common frame of reference when discussing anatomical structures. The anatomical position is the standard reference point for describing the body's position and orientation. In this position:
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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
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Updated: May 9, 2025

Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
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"Hanging Drop Sign" in pelvis X-ray.

C Rex1, A Kesavram1, M Harishkumar1

  • 1Rex Ortho Hospital, Coimbatore, Tamilnadu 641002 India.

Indian Journal of Orthopaedics
|May 5, 2025
PubMed
Summary

The "hanging drop sign" on pelvic X-rays is a common finding in seronegative rheumatoid arthritis (SNRA), appearing more frequently than sacroiliitis. This radiological feature, linked to specific muscle origins, aids in SNRA diagnosis.

Keywords:
EnthesopathyHanging drop signPelvis radiographSeronegative rheumatismSpondyloarthropathy

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Area of Science:

  • Radiology
  • Rheumatology
  • Orthopedics

Background:

  • Diagnosis of Seronegative Rheumatoid Arthritis (SNRA) relies on clinical, radiological, and MRI findings.
  • Plain X-rays are crucial for differential diagnosis in rheumatic disorders.
  • Ischiopubic ramus enthesopathy was identified as a common finding in pelvic X-rays of SNRA patients.

Purpose of the Study:

  • To investigate enthesopathy features in pelvic X-rays of SNRA patients.
  • To identify and characterize a specific radiological finding, termed the "hanging drop sign."
  • To compare the prevalence of this sign with sacroiliitis in SNRA.

Main Methods:

  • Analysis of 152 pelvic X-rays from patients diagnosed with SNRA based on ACR/EULAR and ASAS criteria.
  • Documentation of enthesopathy features, including sacroiliitis and calcification/ossification of pelvic muscle and ligament attachments.
  • A cadaveric study of 10 specimens to determine the anatomical origin of the 'hanging drop sign'.

Main Results:

  • The 'hanging drop sign' was observed in 64 out of 110 (58.18%) SNRA patients with radiological evidence.
  • Sacroiliitis was present in 25 patients (22.72%), and other features were noted in 21 patients.
  • Cadaveric dissection confirmed the 'hanging drop sign' corresponds to the origin of the adductor part of the adductor magnus and gracilis muscles in the ischiopubic ramus.

Conclusions:

  • The 'hanging drop sign' is a common radiological finding in the ischiopubic ramus of patients with seronegative rheumatism.
  • This sign originates from the adductor magnus and gracilis muscles.
  • The 'hanging drop sign' is more prevalent than sacroiliitis and serves as a valuable diagnostic tool for SNRA.