PMC9936914_01
Chest X-ray demonstrating Fleischner's sign (white arrow), Westermark's sign (black arrow), and the knuckle sign (black star).
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PMC9936914_01_jbsr-107-1-3052-g1.jpg
F1
A chest X-ray was ordered as part of her initial workup, showing a concurrent prominent pulmonary artery, focal peripheral hyperlucency due to oligemia and an abrupt tapering of the pulmonary artery (Figure 1).
Coronal contrast-enhanced CT pulmonary angiography image demonstrating emboli filled and enlarged right intermediate pulmonary artery. The pulmonary artery abruptly tapers with due to the blood clot, whose distal end is marked (star).
jbsr-107-1-3052-g2.jpg
PMC9936914_01_jbsr-107-1-3052-g2.jpg
F2
The diagnosis of central pulmonary embolism without signs of infarction was suggested based on the X-ray, prompting the emergency room doctor to request a contrast-enhanced computed tomography (CT) exam, confirming the diagnosis (Figure 2).