Factors related to the failure of radiographic recognition of occult posttraumatic pneumothoraces
Although posttraumatic pneumothoraces (PTXs) are common and potentially life threatening, the supine chest radiograph (CXR) is an insensitive test for their detection. Computed tomography (CT) often identifies occult pneumothoraces (OPTXs). Previous descriptions of OPTX topography have been poor. Ou...
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| Veröffentlicht in: | The American journal of surgery 2005-05, Vol.189 (5), p.541-546 |
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| creator | Ball, Chad G. Kirkpatrick, Andrew W. Laupland, Kevin B. Fox, Dan L. Litvinchuk, Stacey Dyer, Dianne M.M. Anderson, Ian B. Hameed, S. Morad Kortbeek, John B. Mulloy, Rob |
| description | Although posttraumatic pneumothoraces (PTXs) are common and potentially life threatening, the supine chest radiograph (CXR) is an insensitive test for their detection. Computed tomography (CT) often identifies occult pneumothoraces (OPTXs). Previous descriptions of OPTX topography have been poor. Our purpose was to define their distribution and aid in the targeting of thoracic ultrasound.
Posttraumatic supine CXRs and CTs were reviewed for occult, overt, and residual PTXs. PTXs were compared according to their apical, basal, anterior, lateral, medial, and posterior components. A comparative size index was calculated.
Among 761 patients, 338 CT scans revealed 103 PTXs in 89 patients; 55% were OPTXs. OPTXs were apical (57%), basal (41%), anterior (84%), lateral (24%), and medial (27%), with 0% posterior.
CXR missed over half of all PTXs. OPTXs had a greater anterior versus lateral (nearly 4-fold) and both basal and apical versus lateral (2-fold) distribution. OPTXs are often located at easily accessible sonographic windows. |
| doi_str_mv | 10.1016/j.amjsurg.2005.01.018 |
| format | Article |
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Posttraumatic supine CXRs and CTs were reviewed for occult, overt, and residual PTXs. PTXs were compared according to their apical, basal, anterior, lateral, medial, and posterior components. A comparative size index was calculated.
Among 761 patients, 338 CT scans revealed 103 PTXs in 89 patients; 55% were OPTXs. OPTXs were apical (57%), basal (41%), anterior (84%), lateral (24%), and medial (27%), with 0% posterior.
CXR missed over half of all PTXs. OPTXs had a greater anterior versus lateral (nearly 4-fold) and both basal and apical versus lateral (2-fold) distribution. OPTXs are often located at easily accessible sonographic windows.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2005.01.018</identifier><identifier>PMID: 15862493</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Computed tomography ; Female ; Humans ; Injury Severity Score ; Male ; Medical imaging ; Occult pneumothorax ; Occult sciences ; Patients ; Pneumothorax ; Pneumothorax - diagnostic imaging ; Radiography ; Radiography, Thoracic - methods ; Radiology ; Retrospective Studies ; Sensitivity and Specificity ; Statistics, Nonparametric ; Supine Position ; Thoracic Injuries - diagnostic imaging ; Tomography, X-Ray Computed ; Ventilation ; Wounds, Nonpenetrating - diagnostic imaging</subject><ispartof>The American journal of surgery, 2005-05, Vol.189 (5), p.541-546</ispartof><rights>2005 Excerpta Medica Inc.</rights><rights>Copyright Elsevier Limited May 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-9d19b72ed9ba0b6492d41cccd59a0e5752ace38b38c2bcfe0bd6611393b64ef83</citedby><cites>FETCH-LOGICAL-c485t-9d19b72ed9ba0b6492d41cccd59a0e5752ace38b38c2bcfe0bd6611393b64ef83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961005001467$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15862493$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ball, Chad G.</creatorcontrib><creatorcontrib>Kirkpatrick, Andrew W.</creatorcontrib><creatorcontrib>Laupland, Kevin B.</creatorcontrib><creatorcontrib>Fox, Dan L.</creatorcontrib><creatorcontrib>Litvinchuk, Stacey</creatorcontrib><creatorcontrib>Dyer, Dianne M.M.</creatorcontrib><creatorcontrib>Anderson, Ian B.</creatorcontrib><creatorcontrib>Hameed, S. Morad</creatorcontrib><creatorcontrib>Kortbeek, John B.</creatorcontrib><creatorcontrib>Mulloy, Rob</creatorcontrib><title>Factors related to the failure of radiographic recognition of occult posttraumatic pneumothoraces</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Although posttraumatic pneumothoraces (PTXs) are common and potentially life threatening, the supine chest radiograph (CXR) is an insensitive test for their detection. Computed tomography (CT) often identifies occult pneumothoraces (OPTXs). Previous descriptions of OPTX topography have been poor. Our purpose was to define their distribution and aid in the targeting of thoracic ultrasound.
Posttraumatic supine CXRs and CTs were reviewed for occult, overt, and residual PTXs. PTXs were compared according to their apical, basal, anterior, lateral, medial, and posterior components. A comparative size index was calculated.
Among 761 patients, 338 CT scans revealed 103 PTXs in 89 patients; 55% were OPTXs. OPTXs were apical (57%), basal (41%), anterior (84%), lateral (24%), and medial (27%), with 0% posterior.
CXR missed over half of all PTXs. OPTXs had a greater anterior versus lateral (nearly 4-fold) and both basal and apical versus lateral (2-fold) distribution. OPTXs are often located at easily accessible sonographic windows.</description><subject>Abdomen</subject><subject>Computed tomography</subject><subject>Female</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Occult pneumothorax</subject><subject>Occult sciences</subject><subject>Patients</subject><subject>Pneumothorax</subject><subject>Pneumothorax - diagnostic imaging</subject><subject>Radiography</subject><subject>Radiography, Thoracic - methods</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Sensitivity and Specificity</subject><subject>Statistics, Nonparametric</subject><subject>Supine Position</subject><subject>Thoracic Injuries - diagnostic imaging</subject><subject>Tomography, X-Ray Computed</subject><subject>Ventilation</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkV2L1DAUhoMo7rj6E5SCsHedzUeTSa5Ell0VFrzR65AmpzMpbVPzIey_35QZELxQOBBCnrzncB6E3hO8J5iI23Fv5jGVeNxTjPkek1ryBdoReVAtkZK9RDuMMW2VIPgKvUlprFdCOvYaXREuBe0U2yHzYGwOMTURJpPBNTk0-QTNYPxUIjRhaKJxPhyjWU_eVsyG4-KzD8v2FqwtU27WkHKOpswmV2ZdoMwhn0I0FtJb9GowU4J3l_Ma_Xy4_3H3tX38_uXb3efH1naS51Y5ovoDBad6g3vRKeo6Yq11XBkM_MBpDWOyZ9LS3g6AeycEIUyxCsMg2TW6OeeuMfwqkLKefbIwTWaBUJIWB0mo6FgFP_4FjqHEpc6mSdd1dTGc_5vCjFAssdgofqZsDClFGPQa_WziU4X05kmP-uJJb540JrW2YT9c0ks_g_vz6yKmAp_OANSV_fYQdbIeFgvOVwVZu-D_0-IZ8wCntw</recordid><startdate>20050501</startdate><enddate>20050501</enddate><creator>Ball, Chad G.</creator><creator>Kirkpatrick, Andrew W.</creator><creator>Laupland, Kevin B.</creator><creator>Fox, Dan L.</creator><creator>Litvinchuk, Stacey</creator><creator>Dyer, Dianne M.M.</creator><creator>Anderson, Ian B.</creator><creator>Hameed, S. 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Morad ; Kortbeek, John B. ; Mulloy, Rob</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-9d19b72ed9ba0b6492d41cccd59a0e5752ace38b38c2bcfe0bd6611393b64ef83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Abdomen</topic><topic>Computed tomography</topic><topic>Female</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Occult pneumothorax</topic><topic>Occult sciences</topic><topic>Patients</topic><topic>Pneumothorax</topic><topic>Pneumothorax - diagnostic imaging</topic><topic>Radiography</topic><topic>Radiography, Thoracic - methods</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Sensitivity and Specificity</topic><topic>Statistics, Nonparametric</topic><topic>Supine Position</topic><topic>Thoracic Injuries - diagnostic imaging</topic><topic>Tomography, X-Ray Computed</topic><topic>Ventilation</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ball, Chad G.</creatorcontrib><creatorcontrib>Kirkpatrick, Andrew W.</creatorcontrib><creatorcontrib>Laupland, Kevin B.</creatorcontrib><creatorcontrib>Fox, Dan L.</creatorcontrib><creatorcontrib>Litvinchuk, Stacey</creatorcontrib><creatorcontrib>Dyer, Dianne M.M.</creatorcontrib><creatorcontrib>Anderson, Ian B.</creatorcontrib><creatorcontrib>Hameed, S. 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Morad</au><au>Kortbeek, John B.</au><au>Mulloy, Rob</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors related to the failure of radiographic recognition of occult posttraumatic pneumothoraces</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2005-05-01</date><risdate>2005</risdate><volume>189</volume><issue>5</issue><spage>541</spage><epage>546</epage><pages>541-546</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Although posttraumatic pneumothoraces (PTXs) are common and potentially life threatening, the supine chest radiograph (CXR) is an insensitive test for their detection. Computed tomography (CT) often identifies occult pneumothoraces (OPTXs). Previous descriptions of OPTX topography have been poor. Our purpose was to define their distribution and aid in the targeting of thoracic ultrasound.
Posttraumatic supine CXRs and CTs were reviewed for occult, overt, and residual PTXs. PTXs were compared according to their apical, basal, anterior, lateral, medial, and posterior components. A comparative size index was calculated.
Among 761 patients, 338 CT scans revealed 103 PTXs in 89 patients; 55% were OPTXs. OPTXs were apical (57%), basal (41%), anterior (84%), lateral (24%), and medial (27%), with 0% posterior.
CXR missed over half of all PTXs. OPTXs had a greater anterior versus lateral (nearly 4-fold) and both basal and apical versus lateral (2-fold) distribution. OPTXs are often located at easily accessible sonographic windows.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15862493</pmid><doi>10.1016/j.amjsurg.2005.01.018</doi><tpages>6</tpages></addata></record> |
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| ispartof | The American journal of surgery, 2005-05, Vol.189 (5), p.541-546 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Abdomen Computed tomography Female Humans Injury Severity Score Male Medical imaging Occult pneumothorax Occult sciences Patients Pneumothorax Pneumothorax - diagnostic imaging Radiography Radiography, Thoracic - methods Radiology Retrospective Studies Sensitivity and Specificity Statistics, Nonparametric Supine Position Thoracic Injuries - diagnostic imaging Tomography, X-Ray Computed Ventilation Wounds, Nonpenetrating - diagnostic imaging |
| title | Factors related to the failure of radiographic recognition of occult posttraumatic pneumothoraces |
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