Published in:
01-02-2016 | Classics in Abdominal Imaging
The bullet on bodkin sign
Published in: Abdominal Radiology | Issue 2/2016
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A bodkin is a type of medieval arrowhead that tapers to a sharp point, and the “bullet on bodkin” sign (Fig. 1) describes the imaging appearance of a sudden transition of ureteral caliber due to extrinsic encasement [1]. The sign reflects dilation of the ureter proximal to an abrupt site of ureteral narrowing at the level of the pathologic process. The radiographic appearance thus resembles a bullet with its “business end” balanced on the bodkin’s tip (Fig. 2).
Fig. 1
A bullet (white arrow) perched atop a bodkin (yellow arrow)
Fig. 2
Fluoroscopic spot image from a retrograde ureterogram demonstrating a dilated ureter (the “bullet”, white arrow) perched atop the narrowed ureteral segment (the “bodkin, yellow arrow) at the site of transition
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