Original Research Article
Year: 2020 | Month: November | Volume: 10 | Issue: 11 | Pages: 177-181
Prediction of Sensitivity of Supine Chest Radiograph for Detecting Pneumothorax in the Trauma Bay
Sujoy Mani1, Ojaswi Khandediya2, Priti Kapoor3
1JR-1 Radiodiagnosis, MGM Medical College and Hospital, Navi Mumbai.
2JR-3 Radiodiagnosis, MGM Medical College and Hospital, Navi Mumbai.
3Head of Department Radiodiagnosis, MGM Medical College and Hospital, Navi Mumbai.
Corresponding Author: Sujoy Mani
ABSTRACT
Introduction: Pneumothorax is a common complication encountered in the trauma bay in patients presenting with blunt trauma or post RTA. Imaging plays an important role in detecting pneumothorax in the trauma setting. A supine chest radiograph despite its limitations is usually the first investigation that is performed. Computed Tomography of the chest has been considered to be the gold standard in ruling out pneumothorax.
Aims & Objectives: The aim of this study is to predict the sensitivity for detection of pneumothorax on supine chest radiograph on patients in the trauma bay, and compare its sensitivity based on the CT Scan Chest Findings.
Materials & Methods: 100 patients who presented to the Trauma bay were retrospectively evaluated for the presence of pneumothorax on portable supine chest x-ray followed by Computed Tomography of Chest, and the results of both were compared.
Results: Out of the 100 patients that were evaluated, 18 patients showed presence of pneumothorax on Computed Tomography of the Chest. Out of these 18 patients, only 8 were detected with pneumothorax on the supine chest radiograph. The sensitivity of supine chest radiograph was found to be 44.44% for this respective study.
Discussion: The sensitivity of detection of pneumothorax on supine chest radiograph in our study was found to be 44.44%. The supine chest radiograph failed to detect more than half the cases of pneumothorax in the study. The findings of pneumothorax on the supine chest radiograph tend to be subtle and are often hard to detect compared to the CT Scan of the chest. The low sensitivity of the supine chest radiograph alone in the detection of pneumothorax warrants a follow up with CT Scan of the chest which can provide much more additional information.
Conclusion: In the setting of trauma, the sensitivity of detection of pneumothorax on supine chest radiograph remains low. The findings from this study show that a CT Scan is significantly more likely to yield additional information than a supine chest radiograph alone. The supine chest radiograph should be followed up by a CT Scan for better detection and management of pneumothorax. CT Scan of the chest remains the Gold Standard investigation for detection of pneumothorax in the trauma bay.
Key words: Pneumothorax, Supine Chest Radiograph, X-ray, CT Scan, Trauma Bay.