Fat embolism syndrome physical examination: Difference between revisions

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==Physical Examination==
==Physical Examination==
The classic triad of clinical manifestations in fat embolism syndrome include the following:<ref name="pmid3703294">{{cite journal| author=Jacobson DM, Terrence CF, Reinmuth OM| title=The neurologic manifestations of fat embolism. | journal=Neurology | year= 1986 | volume= 36 | issue= 6 | pages= 847-51 | pmid=3703294 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3703294  }} </ref><ref name="pmid8015021">{{cite journal| author=Scopa M, Magatti M, Rossitto P| title=Neurologic symptoms in fat embolism syndrome: case report. | journal=J Trauma | year= 1994 | volume= 36 | issue= 6 | pages= 906-8 | pmid=8015021 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8015021  }} </ref><ref name="pmid3248470">{{cite journal| author=Fu QZ| title=[Early diagnosis and treatment of fat embolism syndrome after multiple fractures]. | journal=Zhonghua Wai Ke Za Zhi | year= 1988 | volume= 26 | issue= 12 | pages= 739-41, 782 | pmid=3248470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3248470  }} </ref><ref name="pmid12684280">{{cite journal| author=Georgopoulos D, Bouros D| title=Fat embolism syndrome: clinical examination is still the preferable diagnostic method. | journal=Chest | year= 2003 | volume= 123 | issue= 4 | pages= 982-3 | pmid=12684280 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12684280  }} </ref>
The classic triad of clinical manifestations seen on physical examination in fat embolism syndrome include the following:<ref name="pmid3703294">{{cite journal| author=Jacobson DM, Terrence CF, Reinmuth OM| title=The neurologic manifestations of fat embolism. | journal=Neurology | year= 1986 | volume= 36 | issue= 6 | pages= 847-51 | pmid=3703294 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3703294  }} </ref><ref name="pmid8015021">{{cite journal| author=Scopa M, Magatti M, Rossitto P| title=Neurologic symptoms in fat embolism syndrome: case report. | journal=J Trauma | year= 1994 | volume= 36 | issue= 6 | pages= 906-8 | pmid=8015021 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8015021  }} </ref><ref name="pmid3248470">{{cite journal| author=Fu QZ| title=[Early diagnosis and treatment of fat embolism syndrome after multiple fractures]. | journal=Zhonghua Wai Ke Za Zhi | year= 1988 | volume= 26 | issue= 12 | pages= 739-41, 782 | pmid=3248470 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3248470  }} </ref><ref name="pmid12684280">{{cite journal| author=Georgopoulos D, Bouros D| title=Fat embolism syndrome: clinical examination is still the preferable diagnostic method. | journal=Chest | year= 2003 | volume= 123 | issue= 4 | pages= 982-3 | pmid=12684280 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12684280  }} </ref>
*[[Petechia|Petechiae]]
*[[Petechia|Petechiae]]
*Neurological deficits<ref name="pmid9793509">{{cite journal| author=Bardana D, Rudan J, Cervenko F, Smith R| title=Fat embolism syndrome in a patient demonstrating only neurologic symptoms. | journal=Can J Surg | year= 1998 | volume= 41 | issue= 5 | pages= 398-402 | pmid=9793509 | doi= | pmc=3949781 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9793509  }} </ref><ref name="pmid19825491">{{cite journal| author=Akhtar S| title=Fat embolism. | journal=Anesthesiol Clin | year= 2009 | volume= 27 | issue= 3 | pages= 533-50, table of contents | pmid=19825491 | doi=10.1016/j.anclin.2009.07.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19825491  }} </ref>
*Neurological deficits<ref name="pmid9793509">{{cite journal| author=Bardana D, Rudan J, Cervenko F, Smith R| title=Fat embolism syndrome in a patient demonstrating only neurologic symptoms. | journal=Can J Surg | year= 1998 | volume= 41 | issue= 5 | pages= 398-402 | pmid=9793509 | doi= | pmc=3949781 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9793509  }} </ref><ref name="pmid19825491">{{cite journal| author=Akhtar S| title=Fat embolism. | journal=Anesthesiol Clin | year= 2009 | volume= 27 | issue= 3 | pages= 533-50, table of contents | pmid=19825491 | doi=10.1016/j.anclin.2009.07.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19825491  }} </ref>
*[[Hypoxemia]]
*[[Hypoxemia]]
===General physical examination===
===General physical examination:===
*Petechiae
*Petechiae: Non-palpable rash
**Classically seen in the non-dependent region such as:
*Appear within 24-36 hours and disappear within a week in 20-50% of patients.
***Axillae
*Classically seen in the non-dependent region such as:
***Conjunctivae  
**Axillae
***Anterior thorax
**Conjunctivae  
***Head and neck
**Anterior thorax
**Head and neck
*Tachypnea
*Tachypnea
*Tachycardia
*Lethargy
*Lethargy
===Neurological exam findings===
*Cyanosis
===Neurological exam findings:===
The following physical exam findings are seen on neurological examination. They are present mainly due to cerebral edema.
*Focal neurological deficit  
*Focal neurological deficit  
*Confusion
*Confusion
*Rigidity
*Convulsions
*Coma
=== Ophthalmological examination: ===
Fundoscopic examination shows the following changes in the retina:
* Exudates
* Intravascular fat globules
* Edema
* Hemorrhage


==References==
==References==

Revision as of 14:45, 1 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Physical Examination

The classic triad of clinical manifestations seen on physical examination in fat embolism syndrome include the following:[1][2][3][4]

General physical examination:

  • Petechiae: Non-palpable rash
  • Appear within 24-36 hours and disappear within a week in 20-50% of patients.
  • Classically seen in the non-dependent region such as:
    • Axillae
    • Conjunctivae
    • Anterior thorax
    • Head and neck
  • Tachypnea
  • Tachycardia
  • Lethargy
  • Cyanosis

Neurological exam findings:

The following physical exam findings are seen on neurological examination. They are present mainly due to cerebral edema.

  • Focal neurological deficit
  • Confusion
  • Rigidity
  • Convulsions
  • Coma

Ophthalmological examination:

Fundoscopic examination shows the following changes in the retina:

  • Exudates
  • Intravascular fat globules
  • Edema
  • Hemorrhage

References

  1. ↑ Jacobson DM, Terrence CF, Reinmuth OM (1986). "The neurologic manifestations of fat embolism". Neurology. 36 (6): 847–51. PMID 3703294.
  2. ↑ Scopa M, Magatti M, Rossitto P (1994). "Neurologic symptoms in fat embolism syndrome: case report". J Trauma. 36 (6): 906–8. PMID 8015021.
  3. ↑ Fu QZ (1988). "[Early diagnosis and treatment of fat embolism syndrome after multiple fractures]". Zhonghua Wai Ke Za Zhi. 26 (12): 739–41, 782. PMID 3248470.
  4. ↑ Georgopoulos D, Bouros D (2003). "Fat embolism syndrome: clinical examination is still the preferable diagnostic method". Chest. 123 (4): 982–3. PMID 12684280.
  5. ↑ Bardana D, Rudan J, Cervenko F, Smith R (1998). "Fat embolism syndrome in a patient demonstrating only neurologic symptoms". Can J Surg. 41 (5): 398–402. PMC 3949781. PMID 9793509.
  6. ↑ Akhtar S (2009). "Fat embolism". Anesthesiol Clin. 27 (3): 533–50, table of contents. doi:10.1016/j.anclin.2009.07.018. PMID 19825491.
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