The chest X ray in pulmonary embolism: Westermark sign, Hampton's Hump and Palla's sign. What's the difference?
Journal Title: Journal of Acute Disease - Year 2018, Vol 7, Issue 3
Abstract
Pulmonary embolism (PE), with the incidence of about 60 per 100 000 annually, can be a lifethreatening disease if it is not treated promptly. It has been estimated that some 10% of PE patients die within the first hour of the event. Untreated PE has a mortality of about 30%. PE is a condition that is treatable if suspected and diagnosed early. The chest radiograph is still the first investigation that is ordered in patients presenting with cardiorespiratory symptoms or symptoms suggestive of PE. The CXR is also helpful in identifying or excluding other conditions or diagnoses. Thus, knowing and understanding some of the more specific CXR signs can be useful. We suggest that physicians to be aware of and utilize CXR findings such as Palla's sign, Westermark sign and Hamptons hump to help with the diagnosis of PE and to exclude other conditions that can mimic venous thrombo-embolism. Even if these signs are not common, their presence, even in an unsuspected patient without a high pretest probability of PE, should prompt further investigations such as a D-dimer test, lung scintigraphy or computed tomography pulmonary angiography as required.
Authors and Affiliations
Tan Si Hong Shawn, Lim Lim Xin Yan, Fatimah Lateef
Keywords
Related Articles
- EP ID EP407364
- DOI 10.4103/2221-6189.236822
- Views 129
- Downloads 0
Using markedly abnormal vital signs in the emergency department to anticipate needs for intensive care unit admission
Objective: To assess the utility and relative strength of markedly abnormal vital signs thresholds (triggers) in prediction of the needs for intensive care unit (ICU) admission from the emergency department (ED). Methods...
Protective effects of crude and alkaloidal extracts of Tamarindus indica against acute inflammation and nociception in rats
Objective: To investigate the anti-inflammatory and antinociceptive effects of total alkaloids extracted from the leaf of Tamarindus indica (T. indica) in rats. Methods: Acetic acid-induced pain and egg albumin-induced i...
Conservative management for acute renal rupture in blunt trauma
Renal injuries are commonly reported in blunt abdominal trauma and are usually associated to other abdominal injuries. Renal rupture may be misdiagnosed and its management, especially in severe lesions, is still controve...
Acute ethanol-related nervous system injuries
Acute ethanol intoxication has a diversity of clinical pictures that extend from mere euphoria to severe neurological impairment culminating in coma. Although the majority of cases have a reversible and benign course, th...
Analysis of the disease spectra in patients seeking emergency medical treatment in Haikou, China
Objective: To explore the characteristics of medical emergency disease spectra in Emergency Department of Haikou, China; and to provide clinical data for emergent disease treatment as well as emergency department personn...