Imaging of blunt pediatric thoracic trauma

The imaging evaluation of thoracic trauma is a central feature of the acute assessment and management of injured children. A reliable early clinical diagnosis of chest injury often is difficult. Cardiopulmonary symptoms may not be present in the first 24 hours, and there is no consistent relationship between external chest wall injury and underlying abnormalities. This is particularly evident in children, in whom increased compliance of the bony thorax allows major internal injury to occur without associated skeletal injury. Additionally, unlike the examination of injuries to the head and abdomen, which are often evaluated with computed tomography in the initial posttraumatic period, chest radiography remains the primary method for evaluation of chest injuries, although it may not demonstrate or may underestimate many abnormalities. This essay reviews the imaging appearance of common and uncommon thoracic injury in children.