Findings
Chest
- Patchy groundglass opacities in the right middle and lower lobes with intermixed cystic lucencies in the right middle lobe
- No pneumothorax
- Focal severe narrowing of the distal right subclavian artery as it traverses the medial margin of the right first rib. No dissection flap is seen extending proximally or distally
Abdomen/Pelvis
- Bilateral punctate nonobstructing renal calculi
MSK
- Acute comminuted right sacral fracture with involvement of the right S1-S4 neural foramina and the right sacroiliac joint without diastasis
- Acute right obturator ring fractures with a superior pubic ramus/pubic root fracture extending into the anterior wall of the right acetabulum, a pubic body fracture without definite extension into the pubic symphysis or symphyseal diastasis, and a segmental right inferior pubic ramus fracture
- Acute minimally displaced fracture of the left pubic root
- Acute nondisplaced fractures of the right anterior third through sixth and right posterior tenth and eleventh ribs
- Small focus of contrast density along the medial aspect of the more posterior right inferior pubic ramus fracture which increases in size on delayed images. Adjacent obturator internus intramuscular hematoma
Diagnosis
Pelvic trauma with arterial hemorrhage
Sample Report
Acute comminuted right sacral fracture and right obturator ring fractures without dislocation or diastasis of the sacroiliac joints or pubic symphysis.
Small area of active hemorrhage adjacent to the right inferior pubic ramus fracture with an adjacent obturator internus intramuscular hematoma.
Acute minimally displaced fracture of the left pubic root.
Right middle and lower lobe pulmonary contusion and/or aspiration with multiple small traumatic pneumatoceles in the right middle lobe. No pneumothorax.
Acute nondisplaced fractures of the right anterior third through sixth and right posterior tenth and eleventh ribs.
Focal severe narrowing of the distal right subclavian artery as it traverses the medial margin of the right first rib. This finding is age-determinate and may represent chronic compression of the subclavian artery, which should be correlated with clinical signs of thoracic outlet syndrome. Superimposed acute artery injury is not excluded, though a dissection flap is not directly visualized.
Discussion