Central Pulmonary Embolism Detected on a Chest X-Ray: A Case Report

Patients presenting to the emergency room with respiratory symptoms often receive a chest X-ray as part of the initial workup to exclude common pathologies. A 60-year-old patient presented to the emergency department with dyspnoea. An initial chest X-ray revealed the Fleischner’s sign, the knuckle sign, and the Westermark sign, specific but not sensitive for central pulmonary embolism, prompting a follow-up angio CT to confirm the diagnosis. The patient was treated and discharged a few days later. TEACHING POINT: Chest X-rays, done as part of an initial workup, can show signs of pathologies that are not yet clinically suspected, such as pulmonary embolism.