Leo Rigler
Leo George Rigler (1896-1979) was an American radiologist.
Worked with the World Health Organization to improve clinical radiology in developing countries including India, Iran and Israel. Published over 200 articles and edited six books
Rigler was the first to point out that the decubitus position was very useful in the diagnosis of small pleural effusions of as little as 100mL of fluid. Eponymously affiliated with Rigler sign; Rigler triad, Rigler notch sign and Hoffman-Rigler sign
Biography
- Born on October 16, 1896, in Minneapolis
- 1920 – MD, University of Minnesota
- 1934 – certified by the American Board of Radiology (68th member)
- 1937 – chairman of radiology at the University of Minnesota (held until 1957)
- 1963 – professor of radiology at the University of California
- Died on October 25, 1979
Medical Eponyms
Rigler sign (1941)
Radiographic sign of pneumoperitoneum. Air in the peritoneum and air within the intraluminal spaces outline the luminal and serosal surfaces of the bowel wall.
Rigler triad (1941)
Imaging findings in patients with gallstone ileus:
- an ectopic gallstone causing
- partial or complete small bowel obstruction, and
- pneumobilia and/or gallbladder lumen gas
Rigler triad: 1. pneumobilia; 2. small bowel obstruction; 3. ectopic calcified gallstone
Case courtesy of Assoc Prof Frank Gaillard. Case rID: 6906
Rigler notch sign (1955)
Indentation in the border of a solid lung mass (thought to represent a nutrient/feeding vessel) and is suggestive of a bronchial carcinoma.
The sign is not pathognomonic of bronchial carcinoma being observed in other conditions, such as granulomatous infections. The sign as a differentiating utility is limited.
Rigler and Heitzman describe the notches pathologically and histologically.
In many histologic section of this small lesion shows an area of blood vessels surrounded by alveoli which is drawn into one side of the tumour. It is possible that the tumour has grown around this stalk, thus resembling the hilus of an organ.
Rigler and Heitzman, Radiology 1955
Fig. 8. Notch sign in a hypernephroma metastasis. A. Planigram showing large nodule in lung with marked indentation on lateral border, fairly characteristic of notch sign. B. Surgical specimen showing a deep groove (arrows) in the tumor corresponding to the notch. C. Microscopic section showing alveoli and blood vessels extending into the margin of the tumor. Radiology 1955
Hoffman-Rigler sign (1965)
Radiological sign of left ventricular enlargement based on the distance between the inferior vena cava (IVC) and left ventricle (LV).
On a lateral chest radiograph, if the distance between the left ventricular border and the posterior border of IVC exceeds 1.8 cm, at a level 2 cm above the intersection of diaphragm and IVC, left ventricular enlargement is suggested.
** Richard Bashefkin Hoffman (1937-2011) and Rigler described their eponymous sign in 1965
Major Publications
- Rigler LG. Roentgen diagnosis of small pleural effusion. JAMA. 1931; 96(2): 104-108.
- Rigler LG. Outline of roentgen diagnosis. 1938
- Rigler LG. Spontaneous pneumoperitoneum: a roentgenologic sign found in the supine position. Radiology 1941; 37: 604–607 [Rigler sign]
- Rigler LG, Borman CN, Noble JF. Gallstone obstruction: pathogenesis and roentgen manifestations. JAMA. 1941; 117(21): 1753-1759. [Rigler Triad]
- Rigler LG. Outline of Roentgen diagnosis an orientation in the basic principles of diagnosis by the Roentgen method. 1943
- Rigler LG. The chest, a handbook of Roentgen diagnosis. 1946
- Rigler LG, Heitzman ER. Planigraphy in the differential diagnosis of the pulmonary nodule, with particular reference to the notch sign of malignancy. Radiology. 1955 Nov;65(5): 692-702. [Rigler notch sign]
- Rigler LG. A roentgen study of the evolution of carcinoma of the lung. J Thorac Surg. 1957 Sep; 34(3): 283-297
- Rigler LG. Functional roentgen diagnosis: anatomical image; physiological interpretation. Am J Roentgenol Radium Ther Nucl Med. 1959 Jul; 82(1): 1-24
- Hoffman R, Rigler L. Evaluation of the left ventricular enlargement in the lateral projection of the chest. Radiology 1965: 85: 93–100. [Hoffman-Rigler sign]
References
Biography
- Heitzman ER. Leo G. Rigler, MD: a personal perspective. Radiology. 2004 Oct;233(1):13-4.
- Lewicki AM. The Rigler sign and Leo G. Rigler. Radiology. 2004 Oct;233(1):7-12
- Linton O. Leo G. Rigler. J Am Coll Radiol. 2005 Dec;2(12):1040-1
- Bibliography. Rigler, Leo G. (Leo George) 1896-1979. WorldCat Identities
Eponymous terms
- Levine MS, Scheiner JD, Rubesin SE, Laufer I, Herlinger H. Diagnosis of pneumoperitoneum on supine abdominal radiographs. AJR Am J Roentgenol 1991; 156(4): 731–735
- Freeman V, Mutatiri C, Pretorius M, Doubell A. Evaluation of left ventricular enlargement in the lateral position of the chest using the Hoffman and Rigler sign. Cardiovasc J S Afr. 2003 May-Jun;14(3):134-7
- Kanne JP, Rohrmann CA Jr, Lichtenstein JE. Eponyms in radiology of the digestive tract: historical perspectives and imaging appearances. Part I. Pharynx, esophagus, stomach, and intestine. Radiographics. 2006 Jan-Feb;26(1):129-42
- Maizlin ZV, Cooperberg PL, Clement JJ, Vos PM, Coblentz CL. People behind exclusive eponyms of radiologic signs (Part II). Can Assoc Radiol J. 2010 Feb;61(1):44-53.
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Third year M.D. student at the University of Notre Dame Fremantle. Passionate about emergency and retrieval medicine, rural practice and clinical research
