Chest X-rays in detecting injuries caused by blunt trauma
Kadir Agladioglu1, Mustafa Serinken2, Onur Dal3
1Department of Radiology, Medical Faculty, Pamukkale University, Denizli, Turkey.
World Journal of Emergency Medicine
|March 24, 2016
Summary
Chest X-ray (CXR) is valuable for blunt chest trauma, especially in unstable patients. Stable patients with normal CXR may still need thoracic computed tomography (TCT) to rule out significant injuries.
Area of Science:
- Radiology
- Emergency Medicine
- Trauma Surgery
Background:
- The optimal imaging sequence for blunt chest trauma remains unclear.
- Thoracic computed tomography (TCT) indications in trauma are not well-defined.
- Chest X-ray (CXR) utility in blunt thoracic trauma needs further evaluation.
Purpose of the Study:
- To determine the diagnostic value of CXR in detecting chest injuries.
- To assess the role of CXR as an initial imaging modality in blunt chest trauma.
- To compare CXR findings with TCT in a trauma population.
Main Methods:
- Retrospective review of 447 blunt thoracic trauma patients (2009-2013).
- Inclusion criteria: age >8, blunt chest injury, hemodynamically stable, neurologically intact.
- Both upright CXR and TCT were performed in the emergency department.
Main Results:
- CXR demonstrated high sensitivity for clavicle fractures (95%CI 78.3%) but low sensitivity for pneumomediastinum (95%CI 11.8%).
- CXR exhibited nearly 100% specificity for various thoracic entities.
- Male patients constituted 69.1% of the cohort, with motor vehicle accidents being the most common cause (35.3%).
Conclusions:
- CXR is the preferred initial imaging for hemodynamically unstable patients with blunt chest trauma.
- Thoracic computed tomography (TCT) is recommended for stable patients with normal CXR if significant injury is suspected.
- CXR plays a crucial role in the initial assessment of blunt chest trauma, guiding further imaging decisions.
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