Pulmonary contusion is a very serious condition after chest injury specially while travelling in a car at speed of more than 40 miles per hour and fall from more than 20 feet height -suggesting rapid deccelration
In a symptomatic patient the first investigation is chest X-Ray,with initial stabilisation of the patient
Chest radiograph may show patchy ground glass opacity,consolidation in non segmental distribution.There will not be lobar distribution and no air bronchogram unlike pneumonia. The opacities will be located peripherally ,sparing the subpleural region
It takes 24 -48 hours to appear the opacity which may appear as crescentic opacity adjacent to the lesion
If the chest radiograph is normal and clinical setting is suggesting pulmonary contusion,NEXUS(National Emergency X Radiograph Utilization Study) guideline should be followed, which says that CT Chest is done in such scenario if there is tendernes over sternum, scapula, thoracic spine,and chest wall or there is seat belt sign.
CT chest may be deferred if there is no rapid deccelration or in absence of above mentioned signs
For more knowledge-Join Fellowship in Pediatric Pulmonology with Bronchoscopy under Respiratory Foundation of India-WhatsApp 9899186848, 9873446805
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