Characteristic imaging findings in pulmonary fat embolism syndrome (FES)

Description

A 21-year-old male presented to the hospital following a road accident. He was riding a motorcycle when he flung into a roadside drain. On arrival, his Glasgow Coma Scale was 15/15 and vital signs were stable. On examination, there was tenderness and deformity of the left thigh. The diagnosis of closed comminuted fractures of the left femur was confirmed following plain radiography. Chest radiograph was normal (figure 1). He was admitted and planned for interlocking nail (ILN) insertion at the left femur. Two days after admission, his blood oxygen saturation (SpO₂) became low at 92% despite 3 L of oxygen. He was febrile and tachycardic. On day 3, he developed chest pain, palpitations and tachypnoea. Oxygen support was escalated to intubation and mechanical ventilation. Chest radiograph then showed diffuse air space opacities bilaterally (figure 1). CT pulmonary angiogram showed diffuse ground-glass opacities and consolidations in both lung...

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