Beyond the Surface: Exploring Chest Trauma With Conventional Radiography and CT

Abstract

BACKGROUND Traumatic injuries to the chest are a frequent cause of mortality among young individuals. Imaging plays a crucial role in the management of thoracic trauma, providing essential details for accurate diagnosis and treatment. OBJECTIVE To assess the respective contributions of radiography and CT in cases of chest trauma. SETTINGS AND DESIGN We assessed 64 subjects, gathering findings from both CT scans and radiographic imaging. The results were organized into a table, considering various variables such as subcutaneous emphysema, rib fractures, clavicular fractures, sternal fractures, scapular fractures, vertebral fractures, pneumothorax, pneumomediastinum, hemothorax, lung contusions, diaphragmatic injuries, and lung herniations. We analyzed the incidence and mode of injury for each variable. Additionally, we compared the sensitivity and specificity of radiographs to CT scans. RESULTS The leading cause of chest trauma was road traffic accidents (RTAs) (67.2%). The most common age groups affected were 18-30 years (31.3%) and 30-40 years (25%). Rib fractures (73.4%), contusions (70.3%), and hemothorax (62.5%) were the most frequently observed findings. Comparing the detection rates of contusions, rib fractures, hemothorax/pleural effusions, pneumothorax/pneumomediastinum, radiographs exhibited lower sensitivity than CT scans (p-value < 0.05 for all comparisons). CONCLUSIONS In the assessment of trauma patients, chest radiographs continue to serve as the primary screening method, while CT scans are the preferred imaging technique. CT scans are preferable to radiographs in subjects who are clinically stable, providing valuable information. However, for subjects who are unstable, CT scans become even more indispensable, as they offer critical insights into their condition.