Pulmonary Contusion

  • Etiology: blunt thoracic trauma
  • Imaging: parenchymal hemorrhage which rapidly appears + resolves, may develop a pneumatocele, CXR underestimates amount of lung injury present compared to CT

Cases of Pulmonary Contusion

CXR and CT of pulmonary contusion
CXR AP shows patchy airspace disease in the right upper lobe which is much better seen on the axial CT with contrast of the chest.
CXR and CT of rib fracture and pulmonary contusion
CXR AP shows cortical irregularities of the right 6th and 7th ribs and no evidence of lung injury. Axial CT of the chest shows a large amount of airspace disease in the right lower lobe and a very small amount of free air anteriorly in the right hemithorax.
CXR and CT of pneumothorax and pulmonary contusion and rib fracture
CXR AP shows a widened mediastinum and a small right-sided pneumothorax. Axial CT with contrast of the chest with lung (above) and bone (below) windows shows air in the pleural space anterior to the right lung and fluid in the pleural space posterior to the right lung as well as airspace disease in the right lower lobe and a cortical disruption through one of the right ribs posteriorly.