Pulmonary Embolism : Chest X-ray Signs

1. Classic presentation is normal X-ray in patient with dyspnea and hypoxia

2. Atelectasis or parenchymal abnormality (68%)

3. Elevated hemidiaphragm

4. Pleural effusion (Felson’s sign – pleural effusion on left > right)

5. Hampton’s hump: peripheral pleural based wedge-shaped density above the diaphragm due to pulmonary infarct

6. Westermark’s sign: is distension of pulmonary vasculature proximal to embolism with loss of vascular markings distally, i.e. localized peripheral oligemia (rare)

7. Palla sign: Enlarged right descending pulmonary artery

8. Fleischner lines: Long curvilinear densities reaching pleural surface

9. Fleischner sign: Dilated pulmonary artery