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Subtle chest x-ray signs of pulmonary thromboembolism: the Palla's and Westermark's signs
  1. Ravindran Rajendran,
  2. Bhupinder Singh,
  3. Prabhavathi Bhat,
  4. 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}

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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 received intravenous antibiotics for 2 days …

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  • Contributors All authors contributed equally.

  • Funding None.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.