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Westermark sign

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Title: Westermark sign  
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Subject: Hampton hump, Rigler's sign, Ring-enhancing lesion, Curschmann's spirals, Whispered pectoriloquy
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Westermark sign

In chest radiography, the Westermark sign is a sign that represents a focus of oligemia (leading to collapse of vessel) seen distal to a pulmonary embolism (PE).[1] While the chest x-ray is normal in the majority of PE cases,[2] the Westermark sign is seen in 2% of patients.[3]

The sign results from a combination of:

  1. the dilation of the pulmonary arteries proximal to the embolus and
  2. the collapse of the distal vasculature creating the appearance of a sharp cut off on chest radiography.

Sensitivity and specificity

The Westermark sign, like Hampton's hump (a wedge shaped, pleural based consolidation associated with pulmonary infarction), has a low sensitivity (11%) and high specificity (92%) for the diagnosis of pulmonary embolism.[4]


  1. ^ Ray J (2003). "Westermark sign and suspected pulmonary embolism.". Can J Cardiol 19 (3): 317; author reply 317.  
  2. ^ Introduction to Chest Radiography.
  3. ^ Worsley D, Alavi A, Aronchick J, Chen J, Greenspan R, Ravin C (1993). "Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study.". Radiology 189 (1): 133–6.  
  4. ^ Gurney J. CT: Diagnosis of Pulmonary Embolism. Available at: Accessed on: November 13, 2006.

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