Hemothorax

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Motorbike accident.

Patient Data

Age: 50
Gender: Male

Radiopaedia's Trauma Radiology Course >> Video On-Demand

Chest X-ray

x-ray
Download
Info

Generally increased density of the right hemithorax compared to the left in a supine trauma patient. This is highly suspicious for a right sided hemothorax especially given the film does not appear rotated. No other definite signs of trauma are seen. 

CT Chest

ct
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial lung
window
This study is a stack
Axial bone
window
Download
Info

Bilateral hemothorax, right greater than left, accounting for the density difference seen on the supine chest x-ray. Mild atelectasis is seen adjacent to the hemothoraces and likely small volume pulmonary contusion in the right lung base where a small traumatic pneumatocele is seen. Subtle inward angulation of multiple anterobasal ribs are consistent with incomplete fractures. A right T10 transverse process fracture was better appreciated on sagittal images and a fracture of the right superior aspect of the T10 vertebral body. Locules of soft-tissue gas are seen near the T10 injury and also near the rib fractures. Trace bilateral pneumothorax is seen anterobasally.  

Case Discussion

This case is a nice example of a supine hemothorax on a trauma chest radiograph being identifiable as a generalized increase in hemithorax density compared to the contralateral side.  

CT Findings

  • Bilateral hemothorax, right greater than left
  • mild atelectasis adjacent to the hemothoraces
  • small pulmonary contusion and traumatic pneumatocele right lung base
  • multiple bilateral anterobasal incomplete rib fractures
  • right T10 transverse process and vertebral body fracture with adjacent locules of gas
  • trace bilateral pneumothorax anterobasally (very tiny!) 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.