September 9, 2009

The Luftsichel Sign

A PA chest radiograph shows low left lung volume, haziness of the left lung with obliteration of the left heart border, a Luftsichel sign (arrowheads).
A lateral chest radiograph shows an anteriorly displaced left major fissure (arrows). The collapsed left upper lobe is up against the anterior chest wall.

Facts: Luftsichel sign
  • Seen on PA chest radiograph of patients with left upper lobe collapse
  • Paraaortic crescent of air with sharp margin extending anywhere from left apex to left superior pulmonary vein
  • Luft = air; sichel = sickle [German]
  • Caused by expansion of superior segment of left lower lobe due to left upper lobe collapse.
  • In adults, it is an important clue to diagnose collapse that may be due to an obstructing endobronchial neoplasm.

Signs of Left Upper Lobe Collapse
  • On PA view: Low left lung volume (elevated diaphragm), haziness of the left lung with obliteration of left heart border, elevated left hilum, near-horizontal course of the left main bronchus, Luftsichel sign
  • On lateral view: Anteriorly displaced major fissure that parallels the anterior chest wall
Blankenbaker DG. The Luftsichel sign. Radiology 1998;208:319-320.

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