Question

Name the sign represented in the image given below.

• A. Mickey mouse sign
• B. String sign
• C. Tillaux sign
• D. Stemmer's sign

Hint:

Three round vessels at the groin like a head with two ears mark the saphenofemoral junction.

Answer 1

The Correct Option is A

Step 1: Read the ultrasound. Three rounded structures sit together: a larger central round vessel with two smaller round vessels on either side, looking like a head with two ears.
Step 2: Name it. This is the 'Mickey Mouse sign'. It represents the normal anatomy at the groin, just below the inguinal crease: the common femoral artery and common femoral vein form the head, with the great saphenous vein as one of the ears.
Step 3: Use it. It is a landmark to identify the saphenofemoral junction during venous duplex ultrasound of the lower limb.
Why the others are wrong: The string sign is a thin barium stream in Crohn's terminal ileitis. Tillaux's sign relates to a mesenteric cyst moving in one plane. Stemmer's sign is a clinical sign of lymphoedema (inability to pinch a skin fold at the toe base).
Ref: UIP consensus document, vein duplex ultrasound (Coleridge-Smith et al).