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REVIEW ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 99-102

The chest X ray in pulmonary embolism: Westermark sign, Hampton's Hump and Palla's sign. What's the difference?


1 Dukes-NUS Graduate Medical School and Yong Loo Lin School of Medicine, National University of Singapore Director, Singhealth Duke NUS Institute of Medical Simulation, Singapore
2 Department of Emergency Medicine, Singapore General Hospital, Singapore

Correspondence Address:
Fatimah Lateef
Department of Emergency Medicine, Singapore General Hospital
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2221-6189.236822

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Pulmonary embolism (PE), with the incidence of about 60 per 100 000 annually, can be a life- threatening disease if it is not treated promptly. It has been estimated that some 10% of PE patients die within the first hour of the event. Untreated PE has a mortality of about 30%. PE is a condition that is treatable if suspected and diagnosed early. The chest radiograph is still the first investigation that is ordered in patients presenting with cardiorespiratory symptoms or symptoms suggestive of PE. The CXR is also helpful in identifying or excluding other conditions or diagnoses. Thus, knowing and understanding some of the more specific CXR signs can be useful. We suggest that physicians to be aware of and utilize CXR findings such as Palla's sign, Westermark sign and Hamptons hump to help with the diagnosis of PE and to exclude other conditions that can mimic venous thrombo-embolism. Even if these signs are not common, their presence, even in an unsuspected patient without a high pretest probability of PE, should prompt further investigations such as a D-dimer test, lung scintigraphy or computed tomography pulmonary angiography as required.


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