Published in:
01-12-2018 | Classics in Abdominal Radiology
The collar button ulcer sign
Published in: Abdominal Radiology | Issue 12/2018
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Collar button ulcers in the colon are associated with colitides which affect the inner layers of the colonic wall. This finding is seen on barium enema examination with deep ulceration through the submucosa. The depth of the ulcer is limited by the circumferential muscular layer giving the appearance of either an ovoid or flattened out ulcer base (Fig. 1), sharing a striking resemblance to the collar buttons which are used to anchor the collar to the shirt as with clerical collars or detachable shirt collars which are much less commonly seen in the current era (Fig. 2).
Fig. 1
Images from air-contrast barium enemas in two different patients demonstrate characteristic collar button ulcers in the descending colon (black arrows). These have a smooth regular appearance in (A) and are more irregular ulcerations in (B)
Fig. 2
Collar buttons have a “dumbbell” shape (A) but when placed in the button hole, the visible portion has the linear neck leading to a disk with an appearance similar to collar button ulcers (B)
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