Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Feb 28, 2012; 4(2): 48-52
Published online Feb 28, 2012. doi: 10.4329/wjr.v4.i2.48
Initial assessment of chest X-ray in thoracic trauma patients: Awareness of specific injuries
Tjeerd S Aukema, Ludo FM Beenen, Falco Hietbrink, Luke PH Leenen
Tjeerd S Aukema, Falco Hietbrink, Luke PH Leenen, Department of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands
Ludo FM Beenen, Department of Radiology, Academic Medical Center, PO Box 22660, 1105 AZ Amsterdam, The Netherlands
Author contributions: Leenen LPH designed the study; Aukema TS, Beenen LFM and Hietbrink F performed the research; Aukema TS wrote the manuscript; all authors approved the manuscript.
Correspondence to: Luke PH Leenen, MD, PhD, FACS, Department of Surgery, University Medical Center Utrecht, G04.228, PO Box 85500, 3508 GA Utrecht, The Netherlands.
Telephone: +31-88-7559882 Fax: +31-30-2541944
Received: June 18, 2011
Revised: September 7, 2011
Accepted: September 14, 2011
Published online: February 28, 2012

AIM: To compare the reported injuries on initial assessment of the chest X-ray (CXR) in thoracic trauma patients to a second read performed by a dedicated trauma radiologist.

METHODS: By retrospective analysis of a prospective database, 712 patients with an injury to the chest admitted to the University Medical Center Utrecht were studied. All patients with a CXR were included in the study. Every CXR was re-evaluated by a trauma radiologist, who was blinded for the initial results. The findings of the trauma radiologist regarding rib fractures, pneumothoraces, hemothoraces and lung contusions were compared with the initial reports from the trauma team, derived from the original patient files.

RESULTS: A total of 516 patients with both thorax trauma and an initial CXR were included in the study. After re-evaluation of the initial CXR significantly more lung contusions (53.3% vs 34.1%, P < 0.001), hemothoraces (17.8% vs 11.0%, P < 0.001) and pneumothoraces (34.4% vs 26.4%, P < 0.001) were detected. During initial assessment significantly more rib fractures were reported (69.8% vs 62.3%, P < 0.001).

CONCLUSION: During the initial assessment of a CXR from trauma patients in the emergency department, a significant number of treatment-dictating injuries are missed. More awareness for these specific injuries is needed.

Keywords: Thoracic radiography, Rib fractures, Hemothorax, Pneumothorax, Pulmonary contusion