Pulmonary embolism chest x ray: Difference between revisions
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'''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org] | '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org] | ||
==Overview== | ==Overview== | ||
Chest | Chest X-Ray findings are common in both patients with and without PE who do not have preexisting cardiovascular disease thus limiting its diagnostic usefullness. | ||
==Chest X-Ray== | |||
*''[[Chest X-ray]]s'' are often done on patients with shortness of breath to help rule-out other causes, such as [[congestive heart failure]] and [[rib fracture]]. Chest X-rays in PE are rarely normal,<ref>{{cite journal | author = Worsley D, Alavi A, Aronchick J, Chen J, Greenspan R, Ravin C | title = Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study. | journal = Radiology | volume = 189 | issue = 1 | pages = 133-6 | year = 1993 | id = PMID 8372182}}</ref> but usually lack [[radiologic sign|sign]]s that suggest the diagnosis of PE. | *''[[Chest X-ray]]s'' are often done on patients with shortness of breath to help rule-out other causes, such as [[congestive heart failure]] and [[rib fracture]]. Chest X-rays in PE are rarely normal,<ref>{{cite journal | author = Worsley D, Alavi A, Aronchick J, Chen J, Greenspan R, Ravin C | title = Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study. | journal = Radiology | volume = 189 | issue = 1 | pages = 133-6 | year = 1993 | id = PMID 8372182}}</ref> but usually lack [[radiologic sign|sign]]s that suggest the diagnosis of PE. | ||
* Other, more ‘classic’ findings include | * Other, more ‘classic’ findings include | ||
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* Only 12% of the CXRs in PIOPED were interpreted as normal | * Only 12% of the CXRs in PIOPED were interpreted as normal | ||
In an observational study, conducted at 52 hospitals in seven countries involving 2,454 patients<ref name="pmid10893356">{{cite journal| author=Elliott CG, Goldhaber SZ, Visani L, DeRosa M| title=Chest radiographs in acute pulmonary embolism. Results from the International Cooperative Pulmonary Embolism Registry. | journal=Chest | year= 2000 | volume= 118 | issue= 1 | pages= 33-8 | pmid=10893356 | doi= | pmc= | url= }} </ref>, [[Cardiomegaly]] was the most common chest radiographic abnormality associated with acute pulmonary embolism; however cardiomegaly did not associate with echocardiographic findings of hypokinesia. | In an observational study, conducted at 52 hospitals in seven countries involving 2,454 patients<ref name="pmid10893356">{{cite journal| author=Elliott CG, Goldhaber SZ, Visani L, DeRosa M| title=Chest radiographs in acute pulmonary embolism. Results from the International Cooperative Pulmonary Embolism Registry. | journal=Chest | year= 2000 | volume= 118 | issue= 1 | pages= 33-8 | pmid=10893356 | doi= | pmc= | url= }} </ref>, [[Cardiomegaly]] was the most common chest radiographic abnormality associated with acute pulmonary embolism; however cardiomegaly did not associate with echocardiographic findings of hypokinesia. | ||
==References== | ==References== |
Revision as of 15:37, 2 December 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]
Overview
Chest X-Ray findings are common in both patients with and without PE who do not have preexisting cardiovascular disease thus limiting its diagnostic usefullness.
Chest X-Ray
- Chest X-rays are often done on patients with shortness of breath to help rule-out other causes, such as congestive heart failure and rib fracture. Chest X-rays in PE are rarely normal,[1] but usually lack signs that suggest the diagnosis of PE.
- Other, more ‘classic’ findings include
- Westermark sign (focal oligemia)
- Hampton hump (a peripheral wedge-shaped density above the diaphragm)
- Palla's sign (an enlarged right descending posteroanterior)
Prosective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study conducted by Stein et al. came up with the following findings[2][3]:
- The most common chest x-ray (CXR) finding is atelectasis, seen in 69% of patient with PE and 58% patient without PE.
- Pleural effusion was found in 47% of patient with PE and 39% patient without PE.
- Only 12% of the CXRs in PIOPED were interpreted as normal
In an observational study, conducted at 52 hospitals in seven countries involving 2,454 patients[4], Cardiomegaly was the most common chest radiographic abnormality associated with acute pulmonary embolism; however cardiomegaly did not associate with echocardiographic findings of hypokinesia.
References
- ↑ Worsley D, Alavi A, Aronchick J, Chen J, Greenspan R, Ravin C (1993). "Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study". Radiology. 189 (1): 133–6. PMID 8372182.
- ↑ Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT; et al. (1991). "Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease". Chest. 100 (3): 598–603. PMID 1909617.
- ↑ Stein PD, Saltzman HA, Weg JG (1991). "Clinical characteristics of patients with acute pulmonary embolism". Am J Cardiol. 68 (17): 1723–4. PMID 1746481.
- ↑ Elliott CG, Goldhaber SZ, Visani L, DeRosa M (2000). "Chest radiographs in acute pulmonary embolism. Results from the International Cooperative Pulmonary Embolism Registry". Chest. 118 (1): 33–8. PMID 10893356.