Presentation
Trauma sustained from dirt bike accident, now in ICU. Fever for investigation.
Patient Data
There is the possibility of left basal lung consolidative opacity, partially obscuring the left hemidiaphragm, suggestive of acute infection.
Prominent bronchovascular markings are noted bilaterally. No sizable effusion nor pneumoperitoneum seen. Old bilateral rib fractures are noted.
Annotated images outlining the cervical collar (blue) and electrocardiograph (ECG) leads (red, yellow, green) from the original frontal chest radiograph.
Case Discussion
This portable radiography case features a chest radiograph and corresponding annotated diagrams that depict the presence of the patient's cervical spine collar and electrocardiograph (ECG) leads.
A cervical collar is clinically indicated for patients with an unstable spine injury. Though such collars are not radiolucent, removing them is not an option in these patients as it will compromise the sole purpose of the collar - to immobilize their cervical spine. This means that such collars will appear as artifacts on radiographs, and their appearance should be recognized.
Electrocardiograph (ECG) leads may often be present in a portable radiograph considering the medical emergency context of such imaging. If these patients have constant cardiac monitoring, these ECG leads can be removed, together with the corresponding electrodes. Otherwise, radiographers can attempt to tidy up these wires so that they do not curl/coil around the region of interest, allowing for more visualization of the lung fields. Apart from obscuring lung lesions, common locations where ECG leads may superimpose important locations include:
lung apices: blocks pneumothorax
lateral lung edges: overlap pneumothorax
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