Which sign on ultrasound is associated with rupture?

• A. Step ladder sign - US
• B. Linguini sign - MRI
• C. Intra-capsular implant rupture
• D. Intracapsular implant rupture

Answer: (A)

The main idea is recognizing ultrasound signs that indicate implant rupture. On ultrasound, the step ladder sign appears as ladder-like, parallel echogenic lines within the implant capsule, produced when the implant shell has ruptured but silicone remains confined inside the fibrous capsule. This ultrasound pattern is the classic cue for intracapsular rupture. By contrast, the linguine sign is described on MRI as folded implant shell within the capsule, signaling intracapsular rupture but not seen on ultrasound. The remaining options describe the rupture itself rather than a specific ultrasound sign, or refer to MRI timing, so the ultrasound-specific clue pointing to rupture is the step ladder sign.