Malagari et al identified findings on high-resolution CT scans of the lungs in patients with mild fat embolism. These findings can help identify patients with subclinical fat embolism and may precede clinical symptoms. The authors are from the National and Kapodistrian University of Athens and the University of British Columbia.


Patient selection: fractures to femur, pelvis and/or other long bones


Timing for CT scan to detect changes: at least 24 hours after traumatic injury (clinical onset of fat emboli syndrome is usually 1-3 days post trauma)


Findings on CT scan:

(1) bilateral ground-glass opacities, which may have a patchy distribution (geophraphical)

(2) thickened interlobular septae

(3) nodular opacities, usually centrilobular


Differential diagnosis:

(1) pulmonary contusion (CT changes seen mainly in first 24 hours after injury)

(2) pulmonary edema (show bronchial cuffing, pleural effusions and/or increased artery/bronchus ratio)

(3) aspiration


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