Publication: Chest radiographic evolution in fat embolism syndrome
Issued Date
2005-12-01
Resource Type
ISSN
01252208
01252208
01252208
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2-s2.0-33244457800
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.88, No.12 (2005), 1854-1860
Suggested Citation
Nisa Muangman, Eric J. Stern, Eileen M. Bulger, Gregory J. Jurkovich, Fred A. Mann Chest radiographic evolution in fat embolism syndrome. Journal of the Medical Association of Thailand. Vol.88, No.12 (2005), 1854-1860. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/16715
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Title
Chest radiographic evolution in fat embolism syndrome
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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.