Fat embolism syndrome physical examination: Difference between revisions
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*[[Hypoxemia]] | *[[Hypoxemia]] | ||
===General physical examination:=== | ===General physical examination:=== | ||
The following findings are seen on general physical examination: | |||
*Petechiae: Non-palpable rash | *Petechiae: Non-palpable rash | ||
*Appear within 24-36 hours and disappear within a week in 20-50% of patients. | *Appear within 24-36 hours and disappear within a week in 20-50% of patients. | ||
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*Lethargy | *Lethargy | ||
*Cyanosis | *Cyanosis | ||
===Neurological exam findings:=== | ===Neurological exam findings:=== | ||
The following physical exam findings are seen on neurological examination. They are present mainly due to cerebral edema.<ref name="pmid11495865">{{cite journal| author=Byrick RJ| title=[Fat embolism and postoperative coagulopathy]. | journal=Can J Anaesth | year= 2001 | volume= 48 | issue= 7 | pages= 618-21 | pmid=11495865 | doi=10.1007/BF03016192 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11495865 }} </ref> | The following physical exam findings are seen on neurological examination. They are present mainly due to cerebral edema.<ref name="pmid11495865">{{cite journal| author=Byrick RJ| title=[Fat embolism and postoperative coagulopathy]. | journal=Can J Anaesth | year= 2001 | volume= 48 | issue= 7 | pages= 618-21 | pmid=11495865 | doi=10.1007/BF03016192 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11495865 }} </ref> | ||
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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:
The following findings are seen on 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.[7]
- Focal neurological deficit
- Confusion
- Rigidity
- Convulsions
- Coma
Ophthalmological examination:
Fundoscopic examination shows the following changes in the retina:[8][9][10]
- Exudates
- Intravascular fat globules
- Edema
- Hemorrhage
References
- ↑ Jacobson DM, Terrence CF, Reinmuth OM (1986). "The neurologic manifestations of fat embolism". Neurology. 36 (6): 847–51. PMID 3703294.
- ↑ Scopa M, Magatti M, Rossitto P (1994). "Neurologic symptoms in fat embolism syndrome: case report". J Trauma. 36 (6): 906–8. PMID 8015021.
- ↑ 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.
- ↑ Georgopoulos D, Bouros D (2003). "Fat embolism syndrome: clinical examination is still the preferable diagnostic method". Chest. 123 (4): 982–3. PMID 12684280.
- ↑ 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.
- ↑ Akhtar S (2009). "Fat embolism". Anesthesiol Clin. 27 (3): 533–50, table of contents. doi:10.1016/j.anclin.2009.07.018. PMID 19825491.
- ↑ Byrick RJ (2001). "[Fat embolism and postoperative coagulopathy]". Can J Anaesth. 48 (7): 618–21. doi:10.1007/BF03016192. PMID 11495865.
- ↑ Murray DG, Racz GB (1974). "Fat-embolism syndrome (respiratory insufficiency syndrome). A rationale for treatment". J Bone Joint Surg Am. 56 (7): 1338–49. PMID 4447657.
- ↑ Herndon JH, Riseborough EJ, Fischer JE (1971). "Fat embolism: a review of current concepts". J Trauma. 11 (8): 673–80. PMID 4935648.
- ↑ Arbus L, Fabre J, Bechac G, Lazorthes Y (1973). "Clinical, ophthalmoscopic and biological findings in systemic fat embolism. Pathogenetic theory and treatment in 30 cases". Acta Neurochir (Wien). 29 (1): 89–104. PMID 4780652.