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Normal supine trauma chest x-ray with rotation

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Fall off garden decking.

Patient Data

Age: 65 years
Gender: Male

Trauma Series

x-ray

Supine chest x-ray in a trauma patient who is significantly rotated. This produces artefactually reduced volume and increased density of the right hemithorax which could easily be misinterpreted as a sign of injury.

Case Discussion

Trauma radiographs are very susceptible to rotational effects due to the difficult imaging environment. In this rotated patient, there is artifactual reduced volume and increased density of the right hemithorax compared to the left which could be misinterpreted as a sign of injury. This patient had no chest abnormality seen on subsequent CT, but had sustained an L1 superior endplate compression fracture.

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