Fat Embolism Differential Diagnoses

Updated: Mar 08, 2022
  • Author: Constantine S Bulauitan, MD; Chief Editor: Vincent Lopez Rowe, MD, FACS  more...
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Diagnostic Considerations

Every effort should be made to look for treatable or life-threatening disorders before the diagnosis of fat embolism syndrome (FES) is made. Computed tomography (CT) of the head is necessary to rule out intracranial pathology. CT of the chest is useful for identifying or ruling out chest pathology, which can often present in a similar fashion. The differential diagnosis on CT includes entities such as the following [21] :

  • Pulmonary contusion - Important distinguishing features include (1) the development of signs and symptoms shortly after trauma, typically within 6 hours, and (2) localized multifocal ground-glass opacitites in the distrubution of the injury
  • Pulmonary edema - This will likely manifest as bilateral symetrically distributed septal lines, ground-glass opacities, vascular engorgement, pleural effusions, or some combination thereof
  • Interstitial lung disease
  • Thromboembolic pulmonary embolism (PE) - This will show intraluminal pulmonary vascular arterial filling defects
  • Aspiration pneumonia - This will have peribronchial opacities on CT with associated infectious signs and symptoms

Differential Diagnoses