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February 5, 1968

Accuracy of Diagnosis of Pulmonary Embolism

Author Affiliations


JAMA. 1968;203(6):432. doi:10.1001/jama.1968.03140060056024

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To the Editor:—  I would like to take issue with the statement in the excellent paper by Hildner and Ormond, entitled "Accuracy of the Clinical Diagnosis of Pulmonary Embolism" (202:564, 1967), that "no feature of routine roentgenograms of the chest was clearly helpful in diagnosing or excluding embolism."In 1964, studies of the size and appearance of the main pulmonary artery in chest roentgenograms of both normal individuals and of 44 patients with verified pulmonary embolism showed an increased width and convexity of the main pulmonary artery segment in more than half of those with embolism. These changes were sometimes quite marked. However, in many instances the increase in size of the pulmonary segment was minimal and subtle, yet quite apparent when compared with any available chest x-ray film of the same patient made prior to the embolism or with chest x-ray films made serially thereafter.Subsequent to publication of