[Ultrasound diagnosis in blunt thoracic trauma]

Aim of the study was to determine the rate of injuries detectable by ultrasonography in patients suffering from blunt thoracic trauma.

Ultrasonography of the thorax was prospectively performed in patients with blunt chest trauma additionally to the routine radiological diagnostic procedures. A comparison between ultrasonography and chest x-ray findings referring to the rate of detection of fractures and pleural effusions was performed.

100 patients were enrolled in the study. 23 of them were examined within 24 hours after the trauma, the remaining 77 were examined with a delay of more than 24 hours. The findings detectable by ultrasonography were the following: fractured rib 65%, fracture of sternum 7%, fracture of clavicle 1%, rib fracture with callus 3%, haematoma of the chest wall 11%, pleural effusion 37%, pneumothorax 1%, atelectasis 8%, pneumonia 1%, lung contusion 18%, splenic rupture 3%. Rib fractures were detected in 36% of the patients and pleural effusions were detected in 11%, respectively, by chest x-ray.

Rib fractures and pleural effusions are commonly diagnosed by ultrasonography in patients with blunt thoracic trauma. Concerning the diagnosis of rib fractures (65% versus 36%) and pleural effusions (37% versus 11%), ultrasonography is superior to chest-x-ray. A new and remarkable result is that subpleural infiltrates which are supposed to be lung contusions are also detectable by ultrasonography.