Cupola sign

Last updated August 17, 2025

The Cupola Sign was described by Mindelzun and McCort in 1986.

Cupola sign

Cupola sign
Differential diagnosis	pneumoperitoneum

The cupola sign is seen on a supine chest or abdominal radiograph in the presence of pneumoperitoneum.

It refers to air that rises within the abdominal cavity of the supine patient to accumulate underneath the central tendon of the diaphragm in the midline. It is seen as lucency overlying the lower thoracic vertebral bodies. The superior border is well defined, but the inferior margin is not.

Term

"Cupola" is an architectural term, referring to a small dome (in particular, a small dome crowning a roof or a turret). The word derives from a Latin word for a "little cup".

References

Mindelzun and McCort, “Cupola Sign: A New Radiographic Sign of Pneumoperitoneum on Supine Abdominal Radiographs.” Radiology. 1986; 158(1): 153–155. doi:10.1148/radiology.158.1.3940261

Marshall Geoffrey B. “The Cupola Sign.” Radiology 241, no. 2 (November 1, 2006): 623–624. doi:10.1148/radiol.2412040700.
Fleming J, Honour H, Pevsner N. The Penguin Dictionary of Architecture: Fourth Edition. Penguin Books. ISBN 0140512411. Read it at Google Books - Find it at Amazon

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