A 2-year-old boy presents with fever, a barking cough, and stridor. In the ED, he is agitated. His vital signs include a temperature of 102.3 F, and a heart rate of 120 beats/minute. Respiration is 28 breaths/minute, and oxygen saturation is 96%. He has mild nasal flaring and subcostal retraction.
Q-1: What is the characteristic finding on this radiograph?
Q-2: Is the radiograph necessary to make the diagnosis?
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Ans-1: Steeple sign, which is a narrowed subglottic air column.
Ans-2: Croup is a clinical diagnosis. X-ray and other laboratory studies are generally not necessary for diagnosis.
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Case History by Muhammed Waseem, MD
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