Pulmonary Infarction: Chest X-ray (Hampton's Hump)

The plain radiograph of a patient with a pulmonary infection can be deceivingly normal without any striking abnormality identifiable. Although several nonspecific radiographic findings can be present (e.g., line shadows, pleural effusions), it’s main value in the case of a suspected lung infarction is to exclude alternative diagnosis (e.g., pneumothorax). Determining the etiology based on radiographic findings, however can be difficult. Segmental consolidation with air bronchograms can be present and appear similarly in lobar pneumonia. Pulmonary embolism may also result in an area of opacity with elevation of the hemidiaphragm, a combination that is typical of atelectasis.

Hampton’s Hump
A rare, but suggestive finding is a wedge-shaped opacity in the periphery of the lung. The base is juxtaposed to the pleural surface, while the rounded apex (i.e., hump) is angled towards the hilum.

Westermark’s sign
Another rare, but suggestive finding is peripheral oligemia (i.e., hyperlucency) in the affected segment of lung. Poor pulmonary vascular perfusion due to an embolism results in a focal, wedged-shaped area of increased blackness. This sign is more helpful if previous radiographs are available for comparison.

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Disclaimer: All the information provided by Medical Education for Visual Learners and associated videos are strictly for informational purposes only; it is not intended as a substitute for medical advice from your health care provider or physician. If you think that you or someone that you know may be suffering from a medical condition, then please consult your physician or seek immediate medical attention.

[swenspud]

This is one of the few helpful things that I have been able to find on this condition. With your expertise would you consider looking at a few x-ray images where CAP was diagnosed in a possible PE situation? At the time the patient had a thrombus in the popliteal vein into the superior peroneal and posterior tibial veins.

[cmhardin]

I don't see anything that looks like a wedge or a hump. Will keep trying.