Final answer:
Typical CXR findings indicative of blunt aortic injury include mediastinal widening, obscuration of the aortic knob, deviation of the trachea, presence of a pleural cap, depressed left mainstem bronchus, and fracture of the first or second rib or sternum. These findings may indicate trauma to the thoracic aorta but require further confirmation with CT angiography.
Step-by-step explanation:
Some characteristic chest X-ray (CXR) findings that could suggest a blunt aortic injury—typically associated with a mechanism of rapid deceleration, such as motor vehicle accidents or falls from significant heights—include the following:
- Mediastinal widening: This indicates potential bleeding into the mediastinum and may suggest aortic injury.
- Obscuration of the aortic knob: This finding can indicate a hematoma that is pressing on the aorta or surrounding structures.
- Deviation of the trachea: A shift of the trachea to the right typically due to mass effect caused by a mediastinal hematoma.
- Presence of a pleural cap or apical cap: This represents blood that has collected at the top of the lung and may indicate trauma to the thoracic structures including the aorta.
- Depressed left mainstem bronchus: Also known as the left bronchial sign, indicative of mass effect from hematoma.
- Fracture of the first or second rib or sternum: Such fractures are associated with a high energy impact and increase the suspicion for great vessel injury, including the aorta.
It is important to note that while these findings can be suggestive of blunt aortic injury, they are not definitive by themselves and further imaging with CT angiography is typically warranted to confirm the diagnosis and assess the extent of injury.