CTICasesFat Embolism Syndrome after Long-Bone Trauma
Imaging findings
In a trauma patient who fell from a ladder sustaining a calcaneal fracture and a tibial plateau fracture, chest CT performed as part of a pan-scan trauma workup shows a very low-attenuation, clearly branching filling defect deep within a pulmonary vessel, confirmed to represent fat rather than streak artifact by comparison with the patient's subcutaneous fat attenuation.
Key takeaways
This is a rare directly visualized fat embolus occupying a sizeable pulmonary vessel, larger than the microscopic fat droplets typically implicated in fat embolism syndrome, and its source could not be clearly explained by the relatively modest lower-extremity fractures present. The patient went on to develop fat embolism syndrome with acute lung injury, and the case was regarded as a rare, memorable finding unlikely to be encountered again.
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See all cases from April 14, 2018 →