CORELATIVE EVALUATION OF POST TRAUMATIC HEMOTHORAX ON PLAIN RADIOGRAPHY AND COMPUTED TOMOGRAPHY

Abstract

BACKGROUND: Post-traumatic hemothorax is the accumulation of blood in the pleural cavity following chest trauma and requires prompt diagnosis to prevent serious complications. Plain radiography is widely used as an initial imaging tool but may miss small or posterior collections. In contrast, Computed Tomography (CT) provides detailed visualization, making it more accurate in detecting hemothorax and associated injuries. However, the correlation between radiographic and CT findings in post-traumatic hemothorax remains insufficiently explored, highlighting the need for comparative evaluation to improve diagnostic accuracy and patient outcomes.

OBJECTIVE: To evaluate the correlation between plain radiography and computed tomography in the assessment of post-traumatic hemothorax.

METHODOLOGY: This cross-sectional observational study was conducted at the Radiology Department of Children Hospital, Lahore, over a period of four months. A total of 40 patients with suspected thoracic trauma were selected through convenient sampling. All patients underwent both plain chest radiography and high-resolution 640-slice CT scanning of the thorax. Imaging included standard PA chest X-rays and thin-slice CT with multiplanar reconstructions. Patients with pre-existing lung disease or incomplete imaging were excluded. Data were analyzed using SPSS version 25.

RESULTS: This study included 40 patients with suspected thoracic trauma, with a male predominance (67.5%). Most participants were young to middle-aged adults, primarily in the 23–30 age group. Chest pain was reported in 47.5% of cases, rib fractures in 37.5%, and dyspnea in 27.5%. CT findings showed hyperdense pleural fluid in 40%, lung collapse in 35%, and atelectasis in 32.5%. On plain radiography, increased density was noted in 45%, blurring of diaphragm and heart borders in 35%, and costophrenic angle abnormalities in 25%. Chi-square analysis revealed no significant associations between key clinical and radiological variables, though a potential trend was observed between hyperdense pleural fluid and costophrenic angle changes. These findings highlight the diagnostic value of CT in detecting post-traumatic hemothorax, often revealing abnormalities that are not clearly evident on chest radiographs.

CONCLUSION: The study concluded that computed tomography (CT) is a valuable diagnostic tool in evaluating thoracic trauma, revealing critical findings such as hyperdense pleural fluid, lung collapse, and atelectasis that may be missed on plain radiography. While chest X-rays showed limited sensitivity, CT provided more detailed assessment, particularly in identifying post-traumatic hemothorax. These results support the use of CT for accurate diagnosis and improved management of thoracic injuries