CTICasesFat Embolism Syndrome
Imaging findings
CT chest images of two distinct patients with long bone fractures who developed acute dyspnea shortly after orthopedic surgery demonstrate extensive, diffuse, somewhat nodular ground-glass opacities with mild interlobular septal thickening (crazy paving) and characteristic subpleural sparing.
Key takeaways
Fat embolism syndrome is a serious complication of long bone fractures and intramedullary instrumentation, typically presenting with dyspnea, hypoxemia, petechiae, and neurological changes within 24 to 72 hours of injury. The typical CT findings of bilateral ground-glass opacities, nodular crazy paving, and subpleural sparing can mimic cardiogenic edema, but the rapid onset post-injury and absence of pleural effusions or cardiomegaly point toward fat microemboli-induced lung injury.
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