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Postgrad Med J doi:10.1136/postgradmedj-2012-131331
  • Images in medicine

Subtle chest x-ray signs of pulmonary thromboembolism: the Palla's and Westermark's signs

  1. Manjunath C Nanjappa
  1. Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India
  1. Correspondence to Dr Ravindran Rajendran, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jaya Nagar 9th Block, BG Road, Bangalore, Karnataka 560069, India; rravi_dr{at}rediffmail.com
  • Received 20 July 2012
  • Revised 3 October 2012
  • Accepted 20 November 2012
  • Published Online First 19 December 2012

Palla's sign,1 dilated right descending pulmonary artery >16 mm, and the Westermark's sign,2 focal oligaemia, are useful chest x-ray signs of pulmonary thromboembolism (PTE) even though their sensitivity and specificity are less. Here, we present a case in which PTE was suspected based on these chest x-ray signs.

A 35-year-old male with fever, right thigh pain, breathlessness and cough was considered to have community-acquired pneumonia, and …


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