Chest radiographic evolution in fat embolism syndrome

Nisa Muangman, Eric J. Stern, Eileen M. Bulger, Gregory Jurkovich, Fred A. Mann

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1854-1860
Number of pages7
JournalJournal of the Medical Association of Thailand
Volume88
Issue number12
StatePublished - Dec 1 2005
Externally publishedYes

Fingerprint

Fat Embolism
Thorax
Wounds and Injuries
Hospitalization
Lung Injury
Pulmonary Edema
Medical Records
Registries
Edema
Lung

Keywords

  • Chest radiograph
  • Fat embolism syndrome
  • Pulmonary edema

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Muangman, N., Stern, E. J., Bulger, E. M., Jurkovich, G., & Mann, F. A. (2005). Chest radiographic evolution in fat embolism syndrome. Journal of the Medical Association of Thailand, 88(12), 1854-1860.

Chest radiographic evolution in fat embolism syndrome. / Muangman, Nisa; Stern, Eric J.; Bulger, Eileen M.; Jurkovich, Gregory; Mann, Fred A.

In: Journal of the Medical Association of Thailand, Vol. 88, No. 12, 01.12.2005, p. 1854-1860.

Research output: Contribution to journalArticle

Muangman, N, Stern, EJ, Bulger, EM, Jurkovich, G & Mann, FA 2005, 'Chest radiographic evolution in fat embolism syndrome', Journal of the Medical Association of Thailand, vol. 88, no. 12, pp. 1854-1860.
Muangman, Nisa ; Stern, Eric J. ; Bulger, Eileen M. ; Jurkovich, Gregory ; Mann, Fred A. / Chest radiographic evolution in fat embolism syndrome. In: Journal of the Medical Association of Thailand. 2005 ; Vol. 88, No. 12. pp. 1854-1860.
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AB - 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.

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