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Radiological appearance in pulmonary embolism

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The plain chest radiograph is better for demonstrating peripheral emboli. The appearances may however be as follows:

  • in central emboli - oligaemic lung fields.
  • peripheral emboli - linear, or sometimes wedge-shaped, shadows may be seen

The appearances of a pulmonary embolus on a plain chest radiograph are sometimes referred to as Westermark's triad.

Other changes that may occur include an elevated diaphragm, some segmental or lobar volume loss, and small effusions (exudate - usually haemorrhagic). Secondary infection of infarcted lung causes cavitation.

Note that it may be difficult to distinguish pulmonary embolism from infection on a chest radiograph.


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