Pulmonary contusion chest x ray: Difference between revisions
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==Chest X Ray== | ==Chest X Ray== | ||
[[Image:Pulmonary contusion.jpg|thumb|right|A chest X-ray showing right sided pulmonary contusion associated with rib fractures and [[subcutaneous emphysema]]]] | [[Image:Pulmonary contusion.jpg|thumb|right|A chest X-ray showing right sided pulmonary contusion associated with rib fractures and [[subcutaneous emphysema]]]] | ||
[[Chest X-ray]] is the most common method used for diagnosis, | [[Chest X-ray]] is the most common method used for diagnosis, and may be used to confirm a diagnosis already made using [[medical sign|clinical signs]].{{cite journal |author=Cohn SM |title=Pulmonary contusion: Review of the clinical entity |journal=Journal of Trauma|volume=42 |issue=5 |pages=973–979 |year=1997 |pmid=9191684}}</ref> Consolidated areas appear white on an X-ray film.<ref name="Fish03"> | ||
{{ | {{ | ||
cite book |author=Fish RM |chapter=Diagnosis and treatment of blast injury |editor=Fish RM, Geddes LA, Babbs CF |title=Medical and Bioengineering Aspects of Electrical Injuries |publisher=Lawyers & Judges Publishing |location=Tucson, AZ |year=2003 |pages=55 |isbn=1-930056-08-7 | cite book |author=Fish RM |chapter=Diagnosis and treatment of blast injury |editor=Fish RM, Geddes LA, Babbs CF |title=Medical and Bioengineering Aspects of Electrical Injuries |publisher=Lawyers & Judges Publishing |location=Tucson, AZ |year=2003 |pages=55 |isbn=1-930056-08-7 | ||
}} | }} | ||
</ref> Contusion is not typically restricted by the anatomical boundaries of the lobes or segments of the lung. | </ref> Contusion is not typically restricted by the anatomical boundaries of the lobes or segments of the lung.<ref name="Strife02">{{cite book |author=Donnelly LF |chapter=CT of Acute pulmonary infection/trauma |editor=Strife JL, Lucaya J|title=Pediatric Chest Imaging: Chest Imaging in Infants and Children |publisher=Springer |location=Berlin |year=2002 |pages=123 |isbn=3-540-43557-3}}</ref> The X-ray appearance of pulmonary contusion is similar to that of [[Pulmonary aspiration|aspiration]],<ref name="Sartorelli04"/> and the presence of[[hemothorax]] or [[pneumothorax]] may obscure the contusion on a radiograph.<ref name="White99"/> Signs of contusion that progress after 48 hours post-injury are likely to be actually due to aspiration, pneumonia, or ARDS.<ref name="Hood89"/> | ||
Although chest radiography is an important part of the diagnosis, it is often not sensitive enough to detect the condition early after the injury.<ref name="Keough01"/> In a third of cases, pulmonary contusion is not visible on the first chest radiograph performed.<ref name="Wanek04">{{cite journal|author=Wanek S, Mayberry JC |title=Blunt thoracic trauma: Flail chest, pulmonary contusion, and blast injury |journal=Critical Care Clinics |volume=20|issue=1 |pages=71–81 |year=2004 |month=January |pmid=14979330 |doi=10.1016/S0749-0704(03)00098-8 }}</ref> It takes an average of six hours for the characteristic white regions to show up on a chest X-ray, and the contusion may not become apparent for 48 hours.<ref name="Wanek04 | Although chest radiography is an important part of the diagnosis, it is often not sensitive enough to detect the condition early after the injury.<ref name="Keough01"/> In a third of cases, pulmonary contusion is not visible on the first chest radiograph performed.<ref name="Wanek04">{{cite journal|author=Wanek S, Mayberry JC |title=Blunt thoracic trauma: Flail chest, pulmonary contusion, and blast injury |journal=Critical Care Clinics |volume=20|issue=1 |pages=71–81 |year=2004 |month=January |pmid=14979330 |doi=10.1016/S0749-0704(03)00098-8 }}</ref> It takes an average of six hours for the characteristic white regions to show up on a chest X-ray, and the contusion may not become apparent for 48 hours.<ref name="Wanek04"/> When a pulmonary contusion is apparent in an X-ray, it suggests that the trauma to the chest was severe and that a CT scan might reveal other injuries that were missed with X-ray.<ref name="Wicky00">{{cite journal |author=Wicky S, Wintermark M, Schnyder P, Capasso P, Denys A |title=Imaging of blunt chest trauma |journal=European Radiology |volume=10 |issue=10 |pages=1524–1538 |year=2000 |pmid=11044920 }}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Chest X Ray
Chest X-ray is the most common method used for diagnosis, and may be used to confirm a diagnosis already made using clinical signs.Cohn SM (1997). "Pulmonary contusion: Review of the clinical entity". Journal of Trauma. 42 (5): 973–979. PMID 9191684.</ref> Consolidated areas appear white on an X-ray film.[1] Contusion is not typically restricted by the anatomical boundaries of the lobes or segments of the lung.[2] The X-ray appearance of pulmonary contusion is similar to that of aspiration,[3] and the presence ofhemothorax or pneumothorax may obscure the contusion on a radiograph.[4] Signs of contusion that progress after 48 hours post-injury are likely to be actually due to aspiration, pneumonia, or ARDS.[5]
Although chest radiography is an important part of the diagnosis, it is often not sensitive enough to detect the condition early after the injury.[6] In a third of cases, pulmonary contusion is not visible on the first chest radiograph performed.[7] It takes an average of six hours for the characteristic white regions to show up on a chest X-ray, and the contusion may not become apparent for 48 hours.[7] When a pulmonary contusion is apparent in an X-ray, it suggests that the trauma to the chest was severe and that a CT scan might reveal other injuries that were missed with X-ray.[8]
References
- ↑ Fish RM (2003). "Diagnosis and treatment of blast injury". In Fish RM, Geddes LA, Babbs CF. Medical and Bioengineering Aspects of Electrical Injuries. Tucson, AZ: Lawyers & Judges Publishing. p. 55. ISBN 1-930056-08-7.
- ↑ Donnelly LF (2002). "CT of Acute pulmonary infection/trauma". In Strife JL, Lucaya J. Pediatric Chest Imaging: Chest Imaging in Infants and Children. Berlin: Springer. p. 123. ISBN 3-540-43557-3.
- ↑
- ↑
- ↑
- ↑
- ↑ 7.0 7.1 Wanek S, Mayberry JC (2004). "Blunt thoracic trauma: Flail chest, pulmonary contusion, and blast injury". Critical Care Clinics. 20 (1): 71–81. doi:10.1016/S0749-0704(03)00098-8. PMID 14979330. Unknown parameter
|month=ignored (help) - ↑ Wicky S, Wintermark M, Schnyder P, Capasso P, Denys A (2000). "Imaging of blunt chest trauma". European Radiology. 10 (10): 1524–1538. PMID 11044920.
- ↑ Le Guen M, Beigelman C, Bouhemad B, Wenjïe Y, Marmion F, Rouby JJ (2007). "Chest computed tomography with multiplanar reformatted images for diagnosing traumatic bronchial rupture: A case report". Critical Care. 11 (5): R94. doi:10.1186/cc6109. PMID 17767714.