A chest X-ray is not a standard diagnostic workup test done for HIT, but it is useful for patients who develop thrombotic complications involving the chest. Chest X-ray can show Hamptom’s hump, Westermark’s sign, or Fleischner’s sign.

A chest X-ray is not typically used to diagnosis HIT. However, if a patient has pulmonary embolism as a thrombotic manifestation of HIT, a chest X-ray can show an acute cardiopulmonary process, such as Hampton’s hump, Westermark’s sign, or Fleischner’s sign.^[1]

• Hampton’s hump refers to a wedge-shaped infarct in the pulmonary parenchyma. This is secondary to embolus resulting in acute occlusion of an arterial branch supplying the pulmonary parenchyma. It was described by Aubrey Hampton in the 1940s. It is also referred to as the melting sign.

• Westermark’s sign refers to distal oligemia (abrupt disruption of blood flow in the pulmonary vessels).^[1] It is also known as the knuckle sign. It is the converse of Fleischner’s sign.

• Fleischner’s sign refers to dilation of the pulmonary vasculature proximal to the obstruction. A pulmonary embolism will cause dilation of the pulmonary artery due to increased back-up pressure in the pulmonary circulation. It is the converse of Westermark’s sign.