“…In cases of acute epiploic appendagitis, US evaluation shows, in the patient's area of maximal tenderness, the presence of a small (2-4 cm in maximal diameter) rounded or ovoid, noncompressible, and hyperechoic mass adherent to the colonic wall, without internal blood flow on color or power Doppler studies, frequently surrounded by a subtle hypoechoic line [11, 16, 22, 23]. The typical CT findings in cases of acute epiploic appendagitis include the presence of rounded or ovoid fat-density mass adjacent to the colonic wall, usually less than 5 cm in diameter (typical diameter range: 1.5–3.5 cm) [11, 19], the “hyperattenuating/hyperdense ring sign” [24], a hyperdense enhancing rim (thickness of 1-3 mm) surrounding the lesion, and the perilesional inflammatory fat stranding [11]. A pathognomonic CT finding of epiploic appendagitis is the “central dot sign”, characterized by a central, ill-defined round area of high attenuation within the fat-density mass [25, 26].…”