Fat Embolism Syndrome Based on the Development of a Preliminary Proposed Framework Requiring Validation: A Narrative...

Fat embolism syndrome (FES) is a potentially life-threatening clinical condition characterized by multisystem dysfunction caused by fat particles entering the circulation, most commonly following trauma or orthopedic procedures. However, early diagnosis remains challenging due to nonspecific clinical manifestations and the limitations of existing diagnostic criteria. This narrative review aims to synthesize current evidence on the clinical features, pathophysiology, diagnostic approaches, imaging characteristics, and management strategies of FES, and to propose updated diagnostic criteria to improve clinical applicability. A narrative review of published studies and clinical reports was conducted to examine the relationship between clinical manifestations, trauma history, and imaging findings. The review highlights the variability in reported incidence, the multisystem involvement of respiratory, neurological, dermatological, and ocular systems, and the evolving role of imaging techniques, particularly magnetic resonance imaging, in detecting cerebral involvement. Based on these findings, we propose a preliminary framework for validation that integrates clinical manifestations, trauma history, and imaging evidence, with defined major criteria, supporting factors, and diagnostic protocols. Although the preliminary proposed criteria may enhance diagnostic specificity and facilitate earlier recognition, limitations remain, including the nonspecificity of certain clinical signs and reliance on advanced imaging resources. Future research should focus on elucidating molecular mechanisms, improving diagnostic tools, and developing targeted therapeutic strategies to optimize clinical outcomes in FES.