Findings
Chest radiograph
- Moderate-sized left pneumothorax
- Patchy left greater than right bibasilar opacities
- Multiple acute left rib fractures and left humeral neck fracture
CT
Chest
- Aortic intimal injury near the diaphragmatic hiatus without external contour abnormality or periaortic hematoma
- Large left pneumothorax with associated rightward mediastinal shift
- Small left hemothorax
- Trace pneumomediastinum
- Dependent left greater than right airspace opacification
- Right lower lobe calcified granulomas
Upper abdomen
- No acute findings
- Subcentimeter hypoattenuating structure in the upper pole of the left kidney, which is too small to characterize
MSK
- Acute minimally displaced segmental fractures of the left second and third ribs
- Acute minimally displaced fractures of the right anterior second and lateral seventh and eighth ribs
- Acute nondisplaced fractures of the left C7, T1, and bilateral T2 transverse processes
- Partially imaged left humeral neck fracture with surrounding mild subcutaneous emphysema
- Multiple metallic densities overlying the patient's back
Diagnosis
Tension pneumothorax
Acute traumatic aortic injury
Sample Report
Large left pneumothorax with associated extensive atelectasis of the left lung and mild rightward mediastinal shift. Recommend correlation with clinical signs of tension.
Mild acute traumatic aortic injury near the diaphragmatic hiatus without surrounding hemorrhage.
Dependent airspace opacities in both lungs likely represent a combination of atelectasis and aspiration.
Acute fractures of the left second and third ribs (which are segmental), right second, seventh, and eighth ribs, and left C7, T1, and bilateral T2 transverse processes.
Partially imaged left humeral neck fracture with surrounding mild subcutaneous emphysema.
Multiple metallic densities overlying the patient's back, which are likely external to the patient. Recommend correlation with direct visual inspection.
Discussion