X-ray Image of Fat Embolism

Fat embolism in a 58-year-old woman who presented with sudden dyspnea. The patient had undergone intramuscular injection of some fatty materials into the buttock several days earlier. (a) Radiograph shows bilateral ground-glass areas of increased opacity. (b) Thin-section (1-mm collimation) CT scan obtained at the level of the aortic arch shows widespread patchy ground-glass attenuation and consolidation. A follow-up radiograph obtained 10 days later (not shown) revealed complete resolution of the ground-glass patterns.
But what is Fat Embolism?
Fat Embolism is an infrequent complication of long bone fracture, occurring in 1%–3% of patients with simple tibial or femoral fractures but in up to 20% of individuals with more severe trauma. Less common causes include hemoglobinopathy, major burns, pancreatitis, overwhelming infection, tumors, blood transfusion, and liposuction. The mechanisms are not completely understood but presumably are twofold. The first mechanism is the production of free fatty acids, which initiates a toxic reaction in the endothelium. The process is further complicated by the accumulation of neutrophils and other inflammatory cells, which causes damage to the vasculature. The second mechanism is the mechanical obstruction of the pulmonary vasculature by fat globules and aggregates of red blood cells and platelets.

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