Fat embolism syndrome (FES) after long bone fracture typically presents with the classic triad 24–72 hours post-injury. The Gurd and Wilson criteria for clinical diagnosis require at least one major and four minor criteria. Which of the following is classified as a MAJOR criterion?

• A Pyrexia >39°C
• B Tachycardia >120/min
• C Thrombocytopenia <150,000
• D Petechial rash in a non-dependent distribution ✓

Explanation

Gurd and Wilson criteria classify FES into major (axillary or subconjunctival petechial rash, hypoxemia PaO2 <60 mmHg on room air, CNS depression unrelated to other cause, pulmonary edema) and minor criteria (tachycardia, pyrexia, retinal emboli, fat globules in urine, sudden drop in hematocrit, high ESR, thrombocytopenia). The petechial rash — classically in non-dependent areas (conjunctivae, neck, upper thorax) — is pathognomonic and a major criterion. Its presence distinguishes FES from other causes of acute respiratory failure post-fracture.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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