Katrina Newbigin1, Carolina A Souza2, Carlos Torres3, Edson Marchiori4, Ashish Gupta5, Joao Inacio6, Mitchel Armstrong7, Elena Peña8. 1. Wesley Hospital, Brisbane, Australia. Electronic address: drnewbigin@gmail.com. 2. The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: csouza@toh.on.ca. 3. The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: catorres@toh.on.ca. 4. Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: edmarchiori@gmail.com. 5. The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: ashgupta@toh.on.ca. 6. The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: jinacio@toh.on.ca. 7. The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: mitarmstrong@toh.on.ca. 8. The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: epena@toh.on.ca.
Abstract
BACKGROUND: Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a combination of a classic triad of symptoms and non-specific, but characteristic radiological features. The aim of this review is to describe the main clinical and imaging aspects of FES, ranging from pathophysiology to treatment with emphasis on pulmonary involvement. METHODS: We reviewed the currently published literature on the main characteristics of FES. RESULTS: In a hypoxic patient with recent trauma or orthopedic surgery, the presence of diffuse, well-demarcated ground glass opacities or ill-defined centrilobular nodules on computed tomography (CT) of the chest are suggestive of FES. CONCLUSIONS: Combination of the classic clinical syndrome in the appropriate clinical setting, together with the characteristic imaging findings on chest CT, can help to achieve the correct diagnosis. Management remains predominantly supportive care, and the benefit of medical therapies such as corticosteroids and heparin remains unclear.
BACKGROUND: Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a combination of a classic triad of symptoms and non-specific, but characteristic radiological features. The aim of this review is to describe the main clinical and imaging aspects of FES, ranging from pathophysiology to treatment with emphasis on pulmonary involvement. METHODS: We reviewed the currently published literature on the main characteristics of FES. RESULTS: In a hypoxicpatient with recent trauma or orthopedic surgery, the presence of diffuse, well-demarcated ground glass opacities or ill-defined centrilobular nodules on computed tomography (CT) of the chest are suggestive of FES. CONCLUSIONS: Combination of the classic clinical syndrome in the appropriate clinical setting, together with the characteristic imaging findings on chest CT, can help to achieve the correct diagnosis. Management remains predominantly supportive care, and the benefit of medical therapies such as corticosteroids and heparin remains unclear.
Authors: David J Birnkrant; Katharine Bushby; Carla M Bann; Benjamin A Alman; Susan D Apkon; Angela Blackwell; Laura E Case; Linda Cripe; Stasia Hadjiyannakis; Aaron K Olson; Daniel W Sheehan; Julie Bolen; David R Weber; Leanne M Ward Journal: Lancet Neurol Date: 2018-02-03 Impact factor: 44.182
Authors: Penance Agbelele; François Van Maris; Mario Sanguina; Bachar Zerkly; Az-Eddine Djebara; Pierre Girard Journal: Radiol Case Rep Date: 2020-07-30