Pneumothorax and Hemothorax: Practical Approaches for Radiologists

Thoracic trauma, particularly pneumothorax and hemothorax, requires rapid and accurate radiologic assessment to reduce morbidity and mortality. Although supine chest radiography remains the initial screening tool, its diagnostic sensitivity is limited in evaluating patients with trauma, necessitating the use of alternative diagnostic tools such as chest ultrasonography. CT serves as the reference standard examination, providing definitive evaluation of the whole thorax and identifying pseudoaneurysms or active contrast extravasation in patients with suspected bleeding. Recently, AI has been developed and integrated into clinical workflows to reduce diagnostic errors. This review discusses standardized radiologic approaches for pneumothorax and hemothorax, focusing on distinctive imaging features, common interpretive pitfalls, structured reporting formats, and the evolving roles of advanced imaging modalities and AI in emergency trauma settings.