Learning Radiology xray montage

S Sign of Golden
Reverse S Sign of Golden


General Considerations

  • S Sign of Golden (AKA Golden’s S Sign, Reverse S Sign of Golden)
  • The shape seen on a frontal radiograph of the chest (and CT) that consists of a mass, typically in the right hilum with associated opacification of the right upper lobe sharply demarcated by the elevated minor fissure
  • The edge produced by the mass and the elevated fissure forms an “S” or “reverse S.”
  • Its significance is its association with a central bronchogenic carcinoma producing the mass and the distal obstructive atelectasis - it is an ominous sign
  • The sign is named after radiologist Ross Golden

 S Sign of Golden

S Sign of Golden. The right upper lobe is atelectatic so the minor fissure is pulled upwards (green arrow) forming part of the "S." There is a mass in the right hilum (red arrow) which is the bronchogenic carcinoma that is causing the obstructive right upper lobe atelectasis and is forming another part of the "S."