title: Fat embolism syndrome: State-of-the-art review focused on pulmonary imaging findings.
abstract: BACKGROUND
  Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a combination of a classic triad of symptoms and non-specific, but characteristic radiological features. The aim of this review is to describe the main clinical and imaging aspects of FES, ranging from pathophysiology to treatment with emphasis on pulmonary involvement.
  
  
  METHODS
  We reviewed the currently published literature on the main characteristics of FES.
  
  
  RESULTS
  In a hypoxic patient with recent trauma or orthopedic surgery, the presence of diffuse, well-demarcated ground glass opacities or ill-defined centrilobular nodules on computed tomography (CT) of the chest are suggestive of FES.
  
  
  CONCLUSIONS
  Combination of the classic clinical syndrome in the appropriate clinical setting, together with the characteristic imaging findings on chest CT, can help to achieve the correct diagnosis. Management remains predominantly supportive care, and the benefit of medical therapies such as corticosteroids and heparin remains unclear.
authors.affiliation: Wesley Hospital, Brisbane, Australia. Electronic address: drnewbigin@gmail.com.
authors.forename: Katrina
authors.initials: K
authors.lastname: Newbigin
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: csouza@toh.on.ca.
authors.forename: Carolina A
authors.initials: CA
authors.lastname: Souza
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: catorres@toh.on.ca.
authors.forename: Carlos
authors.initials: C
authors.lastname: Torres
authors.affiliation: Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: edmarchiori@gmail.com.
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: ashgupta@toh.on.ca.
authors.forename: Ashish
authors.initials: A
authors.lastname: Gupta
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: jinacio@toh.on.ca.
authors.forename: Joao
authors.initials: J
authors.lastname: Inacio
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: mitarmstrong@toh.on.ca.
authors.forename: Mitchel
authors.initials: M
authors.lastname: Armstrong
authors.affiliation: The Ottawa Hospital, Ottawa, Ontario, Canada. Electronic address: epena@toh.on.ca.
authors.forename: Elena
authors.initials: E
authors.lastname: Peña
mesh_terms: D004620:Embolism, Fat / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Fat embolism; High resolution computed tomography; Non thrombotic pulmonary embolism; Pulmonary imaging