Document Detail

Chest radiographic evolution in fat embolism syndrome.
MedLine Citation:
PMID:  16518985     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To characterize the temporal chest radiographic findings of fat embolism syndrome. MATERIAL AND METHOD: Twenty-nine patients with clinically diagnosed fat embolism syndrome between 1988-1999 were retrospectively identified from the Trauma Registry of Haborview Medical Center, University of Washington. In twenty-two patients, complete medical records and serial chest radiographs were available. All images were reviewed by a dedicated thoracic radiologist. RESULTS: Two of 22 patients had normal radiographs throughout hospitalization, while 20/22 developed abnormal chest radiographs. The radiographic findings were consistent with non-specific diffuse pulmonary edema in all abnormal cases. The time to appearance of evident radiographic lung injury was < 24 hours of initial trauma in 10/20 (50%), between 24-48 hours in 4/20 (20%), between 48-72 hours in 5/20 (25%), and 1 patient (1/20, 5%) developed an abnormal chest radiograph after 72 hours. Ten of 20 patients (50%) with abnormal radiographs had complete resolution of the edema pattern within 1 week of development of opacities, 3/20 (15%) cases showed complete radiographic resolution between 1-2 weeks, 2/20 (10%) cases showed complete radiographic resolution between 2-3 weeks, 1/20 (5%) showed complete radiographic resolution between 3-4 weeks, and 4/20 (20%) died without resolution of the radiographic finding. CONCLUSION: The chest radiographic appearance of fat embolism syndrome is non-specific. Normal radiographs can also be seen. Most patients presenting with a normal initial radiograph develop radiographic evident abnormalities within 72 hours of injury and most cases showed radiographic resolution within 2 weeks of hospitalization. Although chest imaging play a little role in the clinical management of fat embolism syndrome, understanding of temporal presentation and evolution of the otherwise non-specific pulmonary opacities may help to avoid unnecessary evaluation in selected patients.
Nisa Muangman; Eric J Stern; Eileen M Bulger; Gregory J Jurkovich; Fred A Mann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Medical Association of Thailand = Chotmaihet thangphaet     Volume:  88     ISSN:  0125-2208     ISO Abbreviation:  J Med Assoc Thai     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-03-07     Completed Date:  2006-04-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7507216     Medline TA:  J Med Assoc Thai     Country:  Thailand    
Other Details:
Languages:  eng     Pagination:  1854-60     Citation Subset:  IM    
Department of Radiology, Faculty of Medicine, Siriaj Hospital, 2 Prannok Rd, Bangkoknoi, Bangkok 10700, Thailand.
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MeSH Terms
Embolism, Fat / complications,  radiography*
Middle Aged
Pulmonary Edema / etiology,  radiography
Pulmonary Embolism / complications,  radiography*
Radiography, Thoracic*

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