Mickey Mouse sign

Mickey Mouse sign is a medical sign resembling the head of Mickey Mouse, the Walt Disney character. Presented for the very first time at the CHIVA's Meeting, Berlin 2002 by Dr. Lurdes Cerol,{{fact|date=February 2024}} this sign has been described as the image at the groin when a dilated accessory saphenous vein (ASV) exists: the common femoral vein (CFV) represents the head of Mickey Mouse while the great saphenous vein (GSV) and the dilated accessory saphenous vein (ASV) represent the ears. The presence of a Mickey Mouse sign has been a great diagnostic clue to check ASV insufficiency.

{{multiple image

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|image1=Mickey mouse sign.png|thumb|Mickey Mouse Sign, the original slide, at CHIVA's Meeting, Berlin 2002"]]

|caption1=Mickey Mouse Sign, the original slide, at CHIVA's Meeting, Berlin 2002"

|image2=Mickey mouse sign1.svg|thumb|Mickey Mouse sign in the saphenofemoral junction, showing GSV, CFA, CFV]]

|caption2=Mickey Mouse sign in the saphenofemoral junction, showing GSV, a dilated ASV and CFV

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Some authors, inspired by this sign, described an ecographic "Mickey Mouse View" at the saphenofemoral junction in the groin: the common femoral vein (CFV) represents the head of Mickey Mouse while the great saphenous vein (GSV) and the accessory saphenous vein (ASV) represent the ears.{{cite journal | vauthors = Coleridge-Smith P, Labropoulos N, Partsch H, Myers K, Nicolaides A, Cavezzi A | title = Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs--UIP consensus document. Part I. Basic principles | journal = European Journal of Vascular and Endovascular Surgery | volume = 31 | issue = 1 | pages = 83–92 | date = January 2006 | pmid = 16226898 | doi = 10.1016/j.ejvs.2005.07.019 | doi-access = free }}

But it can be seen in different regions of the body:

• Midbrain of progressive supranuclear palsy (PSP).{{cite journal | vauthors = Sonthalia N, Ray S | title = The Hummingbird sign: a diagnostic clue for Steele-Richardson-Olszweski syndrome | journal = BMJ Case Reports | volume = 2012 | pages = bcr2012006263 | date = September 2012 | pmid = 22987902 | pmc = 4543120 | doi = 10.1136/bcr-2012-006263 }}
• Polyostotic Paget's disease (Paget's disease affecting multiple bones); a bone scintigraphy with technetium-99m methylene bisphosphonate shows increased uptake at the sites of disease activity. Increased scintigraphic uptake in the body and spine of the vertebrae resembles the head of Mickey Mouse.{{Cite journal | vauthors = Goyal A, Boro H | title = Mickey Mouse sign in a case of polyostotic Paget's disease | journal = Indian Journal of Case Reports | date = November 2017 | volume = 3 | issue = 4 | pages = 279–80 | doi = 10.32677/IJCR.2017.v03.i04.038 | doi-access = free }}
• The portal triad in biliary ultrasound scans, with the portal vein comprising Mickey's head and the common bile duct and hepatic artery his right and left ears, respectively.{{Cite book|url=https://books.google.com/books?id=Dj8taWp2BEgC&pg=PA58|title=Atlas of Emergency Ultrasound|last=Fox|first=J. Christian|date=2011-10-13|publisher=Cambridge University Press|isbn=9781139499873|language=en}}
• Pelvic Mickey Mouse sign: bilateral inguinal vesical hernia on transverse axial imaging.{{cite journal | vauthors = Singh O, Kekre NS | title = "Flying-saucer in the pelvis" sign: An equivalent of "pelvic Mickey mouse" sign | journal = Indian Journal of Urology | volume = 33 | issue = 2 | pages = 173–174 | date = 2017 | pmid = 28469311 | pmc = 5396411 | doi = 10.4103/0970-1591.203423 | doi-access = free }}
• Dysmorphic Mickey Mouse RBCs: RBCs with irregular cell walls and migration of hemoglobin into some areas creating the shape of Mickey Mouse ears.{{Cite book|url=https://books.google.com/books?id=rq40DgAAQBAJ&pg=PA132|title=Clinical Pediatric Nephrology|last1=Kher|first1=Kanwal|last2=Schnaper|first2=H. William|last3=Greenbaum|first3=Larry A.|date=2016-11-25|publisher=CRC Press|isbn=9781482214635|language=en}} The presence of these dysmorphic cells in urine may indicate intraglomerular haemorrhage.{{Cite book|url=https://books.google.com/books?id=3PJVLH1NmQAC&pg=PA539|title=Clinical Laboratory Medicine|last=McClatchey|first=Kenneth D.|date=2002|publisher=Lippincott Williams & Wilkins|isbn=9780683307511|language=en}}
• Ureteropelvic junction obstruction (UPJO){{Cite book|url=https://books.google.com/books?id=c4xAdJhIi6oC&pg=PT76|title=Essentials of Nephrology, 2/e|last=Visveswaran|first=kasi|date=2009|publisher=BI Publications Pvt Ltd|isbn=9788172253233|language=en}}