Thumb and Little Finger Signs

A pair of findings on plain lateral films of the neck; the ‘thumb’ is seen in acute epiglottitis and corresponds to an oedematous aryepiglottic fold—epiglottic shadow—with near-complete obliteration of the valleculae and pyriform sinuses, likened to an adult’s thumb; the ‘little finger’ is used for comparison, where the epiglottic shadow is svelte, resembling an adult’s little finger