In radiology, the steeple sign is a radiologic sign found on a frontal neck radiograph where subglottic tracheal narrowing produces the shape of a church steeple within the trachea itself.[1][2] The presence of the steeple sign supports a diagnosis of croup, usually caused by paramyxoviruses.[3] It can also be defined as the replacement of the usual squared-shoulder appearance of the subglottic area by cone-shaped narrowing just distal to the vocal cords. This is called the steeple or pencil-point sign.
| Steeple sign | |
|---|---|
 | |
| The steeple sign as seen on an anteroposterior neck X-ray of a child with croup | |
| Differential diagnosis | Croup |
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