CTICasesLupus Serositis (Pleural and Pericardial Effusions)
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Imaging findings
Frontal radiograph showed bilateral pleural effusions. Lateral radiograph demonstrated a 'sandwich sign' or 'oreo cookie sign,' indicating a pericardial effusion. Sagittal reformat confirmed the epicardial fat, pericardial effusion, and subtle fat stripe between the pericardium and chest wall, consistent with serositis.
Key takeaways
Lupus (Systemic Lupus Erythematosus) is a common cause of serositis, which can manifest as pleural and/or pericardial effusions. In a young to middle-aged woman presenting with both effusions, lupus should be high on the differential diagnosis. The 'sandwich sign' or 'oreo cookie sign' is a useful radiographic indicator of pericardial effusion.
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