Pertinent Chest x-ray Findings in the Trauma Patient and Implications Respiratory distress without x-ray findings - Central nervous system (CNS) injury, aspiration, traumatic asphyxia Any rib fracture - Pneumothorax, pulmonary contusion Fracture of first three ribs or sternoclavicular fracture-dislocation - Airway or great vessel injury Fracture of lower ribs 9 to 12 - Abdominal injury Two or more rib fractures in two or more places - Flail chest, pulmonary contusion Scapular fracture - Great vessel injury, pulmonary contusion, brachial plexus injury Mediastinal widening - Great vessel injury, sternal fracture, thoracic spine injury Persistent large pneumothorax or air leak after chest tube insertion - Bronchial tear Mediastinal air - Esophageal disruption, tracheal injury, pneumoperitoneum Gastrointestinal (GI) gas pattern in the chest (loculated air) - Diaphragmatic rupture NG tube in the chest - Diaphragmatic rupture or ruptured esophagus Air fluid level in the chest - Hemopneumothorax or diaphragmatic rupture Disrupted diaphragm - Abdominal visceral injury Free air under the diaphragm - Ruptured hollow abdominal viscus #cxr #chestxray #trauma #diagnosis #signs #radiology
