Pulmonary embolism chest x ray
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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.