Fat embolism syndrome physical examination: Difference between revisions

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* Edema
* Edema
* Hemorrhage
* Hemorrhage
*Retinal scotomata (Purtscher's retinopathy)


==References==
==References==

Revision as of 23:57, 1 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Physical Examination

The classic triad of clinical manifestations seen on physical examination in fat embolism syndrome include the following:[1][2][3][4]

General physical examination:

The following findings are seen on general physical examination:

  • Petechiae: Non-palpable rash
  • Appear within 24-36 hours and disappear within a week in 20-50% of patients.
  • Classically seen in the non-dependent region such as:
    • Axillae
    • Conjunctivae
    • Anterior thorax
    • Head and neck
  • Tachypnea
  • Tachycardia
  • Lethargy
  • Cyanosis

Neurological exam findings:

The following physical exam findings are seen on neurological examination. They are present mainly due to cerebral edema.[7]

  • Focal neurological deficit
  • Confusion
  • Rigidity
  • Convulsions
  • Coma

Ophthalmological examination:

Fundoscopic examination shows the following changes in the retina:[8][9][10]

  • Exudates
  • Intravascular fat globules
  • Edema
  • Hemorrhage
  • Retinal scotomata (Purtscher's retinopathy)

References

  1. Jacobson DM, Terrence CF, Reinmuth OM (1986). "The neurologic manifestations of fat embolism". Neurology. 36 (6): 847–51. PMID 3703294.
  2. Scopa M, Magatti M, Rossitto P (1994). "Neurologic symptoms in fat embolism syndrome: case report". J Trauma. 36 (6): 906–8. PMID 8015021.
  3. Fu QZ (1988). "[Early diagnosis and treatment of fat embolism syndrome after multiple fractures]". Zhonghua Wai Ke Za Zhi. 26 (12): 739–41, 782. PMID 3248470.
  4. Georgopoulos D, Bouros D (2003). "Fat embolism syndrome: clinical examination is still the preferable diagnostic method". Chest. 123 (4): 982–3. PMID 12684280.
  5. Bardana D, Rudan J, Cervenko F, Smith R (1998). "Fat embolism syndrome in a patient demonstrating only neurologic symptoms". Can J Surg. 41 (5): 398–402. PMC 3949781. PMID 9793509.
  6. Akhtar S (2009). "Fat embolism". Anesthesiol Clin. 27 (3): 533–50, table of contents. doi:10.1016/j.anclin.2009.07.018. PMID 19825491.
  7. Byrick RJ (2001). "[Fat embolism and postoperative coagulopathy]". Can J Anaesth. 48 (7): 618–21. doi:10.1007/BF03016192. PMID 11495865.
  8. Murray DG, Racz GB (1974). "Fat-embolism syndrome (respiratory insufficiency syndrome). A rationale for treatment". J Bone Joint Surg Am. 56 (7): 1338–49. PMID 4447657.
  9. Herndon JH, Riseborough EJ, Fischer JE (1971). "Fat embolism: a review of current concepts". J Trauma. 11 (8): 673–80. PMID 4935648.
  10. Arbus L, Fabre J, Bechac G, Lazorthes Y (1973). "Clinical, ophthalmoscopic and biological findings in systemic fat embolism. Pathogenetic theory and treatment in 30 cases". Acta Neurochir (Wien). 29 (1): 89–104. PMID 4780652.