CTICasesFat Embolism Syndrome
Imaging findings
Chest radiograph shows a rapid development of diffuse bilateral alveolar and interstitial infiltrates (acute lung injury pattern) following intramedullary nailing of a femur fracture. Notably, there is sparing of the right upper lobe, which corresponds to the distribution of pre-existing pulmonary emboli demonstrated on a CT angiography two days prior.
Key takeaways
Fat embolism syndrome is a known complication of long bone fractures and orthopedic procedures such as intramedullary nailing. The classic chest radiograph shows bilateral consolidations and ground-glass opacities. Upper lobe sparing due to pre-existing pulmonary arterial occlusion illustrates the hemodynamic nature of fat emboli distribution, which follows active pulmonary blood flow.
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