Pulmonary embolism chest x ray: Difference between revisions
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===Chest X-Ray=== | ===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 | *''[[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 | ||
*:*[[Westermark sign]] (focal oligemia) | *:*[[Westermark sign]] (focal oligemia) | ||
| Line 16: | Line 13: | ||
*:*Palla's sign (an enlarged right descending posteroanterior) | *:*Palla's sign (an enlarged right descending posteroanterior) | ||
'''P'''rosective '''I'''nvestigation '''O'''f '''P'''ulmonary '''E'''mbolism '''D'''iagnosis (PIOPED)study conducted by Stein et al. came up with the following findings<ref name="pmid1909617">{{cite journal| author=Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT et al.| title=Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. | journal=Chest | year= 1991 | volume= 100 | issue= 3 | pages= 598-603 | pmid=1909617 | doi= | pmc= | url= }} </ref><ref name="pmid1746481">{{cite journal| author=Stein PD, Saltzman HA, Weg JG| title=Clinical characteristics of patients with acute pulmonary embolism. | journal=Am J Cardiol | year= 1991 | volume= 68 | issue= 17 | pages= 1723-4 | pmid=1746481 | doi= | pmc= | url= }} </ref>: | |||
* 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 | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:02, 22 November 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 XRay 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
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.