Fat Embolism Syndrome: The Ambiguity of Diagnosis in the Postarthroplasty Patient: A Case Report

Do you know the diagnostic importance of susceptibility-weighted imaging on MRI for patients with cerebral fat embolism?

Key Clinical Message

If you suspect cerebral fat embolism (CFE) of the diagnosis for the patients who present with impaired consciousness and hypoxia following a fracture, susceptibility-weighted imaging should be included of head MRI imaging.

Abstract

We report a case of cerebral fat embolism (CFE) that could be identified only by susceptibility-weighted imaging (SWI). Collection and analysis of previous case reports of CFE revealed utilization of SWI in less than one third of suspected cases, despite its known diagnostic ability for CFE.

Early acute fat embolism syndrome caused by femoral fracture: A case report

BACKGROUND

Fat embolism syndrome (FES) is a rare complication caused by the presence of fat particles in the microcirculation, which usually occurs within 12-72 h after trauma. At present, there have been few cases of fat embolism presenting within 3 h after trauma. Here, we report a case of femoral fracture complicated with an acute fat embolism caused by a car accident.

CASE SUMMARY

A 29-year-old woman with pain, swelling and limited movement of her left lower limb after a car accident was taken by ambulance to our hospital. X-ray examination showed fracture of the middle and lower part of the left femur and fracture of the base of the left fifth metatarsal bone. She was hospitalized and admitted to the orthopedic ward. After the attending doctor performed tibial tubercle bone traction, the patient became confused, followed by respiratory distress. Finally, she was transferred to the intensive care unit. After nearly a month of treatment in the intensive care unit, the patient's cognitive function gradually recovered over 6 mo.

CONCLUSION

For patients with early traumatic fractures, young emergency physicians and orthopedics should be aware of the possibility of FES.