Chest X-rays in detecting injuries caused by blunt trauma

Abstract

BACKGROUND:The appropriate sequence of different imagings and indications of thoracic computed tomography (TCT) in evaluating chest trauma have not yet been clarifi ed at present. The current study was undertaken to determine the value of chest X-ray (CXR) in detecting chest injuries in patients with blunt trauma. METHODS:A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department (ED) in the period of 2009-2013 were retrospectively reviewed. The patients met inclusion criteria (age>8 years, blunt injury to the chest, hemodynamically stable, and neurologically intact) and underwent both TCT and upright CXR in the ED. Radiological imagings were re-interpreted after they were collected from the hospital database by two skilled radiologists. RESULTS:Of the 447 patients, 309 (69.1%) were male. The mean age of the 447 patients was 39.5±19.2 (range 9 and 87 years). 158 (35.3%) patients were injured in motor vehicle accidents (MVA). CXR showed the highest sensitivity in detecting clavicle fractures ] but the lowest in pneuomediastinum ]. The specifi city of CXR was close to 100% in detecting a wide array of entities.CONCLUSION: CXR remains to be the fi rst choice in hemodynamically unstable patients with blunt chest trauma. Moreover, stable patients with normal CXR are candidates who should undergo TCT if signifi cant injury has not been ruled out.

Urban thoracic trauma: diagnosis and initial treatment of non-cardiac injuries in adults

“…Upon arrival at the emergency department, chest X-rays (CXR) are the most commonly conducted initial examinations (12). Hemodynamically unstable patients should prioritize CXRs as the primary radiological assessment (13). CXRs can reveal injuries to major thoracic vessels, rib fractures, mediastinal widening, pneumothorax, or haemothorax (11).…”

Imaging Assessment of Thoracic Cage Injuries

“…21 The standard chest radiograph (CR) is specific (100%) but not sensitive (< 50%). 14,[22][23][24][25] CRs should be obtained in the PA and lateral views in the upright position and at full inspiration, although the supine position in anteroposterior (AP) projection is commonly used in trauma patients (►Fig. 1).…”

“…They are usually diagnosed with AP CR. 22 US can diagnosis a clavicle fracture with a sensitivity and specificity of nearly 90%. 14 Sternoclavicular dislocation represents 1 to 3% of all types of dislocations.…”