Unstable pelvic fractures, such as vertical shear and AP compression injury, are associated with higher rates of active hemorrhage, which can be accurately diagnosed by CTA and may require either surgical or vascular interventional treatment [27]. MRI Abdomen and Pelvis Blunt abdominal trauma is not typically evaluated by MRI because of the time of acquisition. However, some sites are moving toward the use of MRI in selected patients [28]. US Abdomen Although US may be able to diagnose certain abdominal injuries, its relatively lower specificity compared with CT does not make it a sufficient test to fully exclude abdominal injuries [29]. Bowel injury is a specific setting for which US is limited because of bowel gas. US FAST Scan Chest Abdomen Pelvis The role of FAST is primarily one of triage; a positive FAST and signs of hemodynamic instability may lead to immediate surgical intervention rather than CT. Although US may be able to diagnose certain thoracic and abdominal injuries, its relatively lower specificity compared with CT does not make it a sufficient test to exclude injuries to these areas [5]. US is not well suited for evaluation of bowel injury because significant fluid trapped in the mesentery may not be detected by FAST. Radiography Trauma Series Trauma series radiographs typically consist of portable radiographs of the chest and pelvis. A portable AP chest radiograph helps screen for immediately life-threatening findings, such as tension pneumothorax and significant mediastinal injury, as well as confirms line placement [13]. A portable radiograph of the pelvis can evaluate for unstable pelvic injuries and hip dislocation [4]. There is no literature to support the use of trauma series radiographs in the detection of bowel injury. Variant 6: Major blunt trauma. Hemodynamically stable. Suspected urinary system, including urethra trauma. Initial imaging.
Major Blunt Trauma. Unstable pelvic fractures, such as vertical shear and AP compression injury, are associated with higher rates of active hemorrhage, which can be accurately diagnosed by CTA and may require either surgical or vascular interventional treatment [27]. MRI Abdomen and Pelvis Blunt abdominal trauma is not typically evaluated by MRI because of the time of acquisition. However, some sites are moving toward the use of MRI in selected patients [28]. US Abdomen Although US may be able to diagnose certain abdominal injuries, its relatively lower specificity compared with CT does not make it a sufficient test to fully exclude abdominal injuries [29]. Bowel injury is a specific setting for which US is limited because of bowel gas. US FAST Scan Chest Abdomen Pelvis The role of FAST is primarily one of triage; a positive FAST and signs of hemodynamic instability may lead to immediate surgical intervention rather than CT. Although US may be able to diagnose certain thoracic and abdominal injuries, its relatively lower specificity compared with CT does not make it a sufficient test to exclude injuries to these areas [5]. US is not well suited for evaluation of bowel injury because significant fluid trapped in the mesentery may not be detected by FAST. Radiography Trauma Series Trauma series radiographs typically consist of portable radiographs of the chest and pelvis. A portable AP chest radiograph helps screen for immediately life-threatening findings, such as tension pneumothorax and significant mediastinal injury, as well as confirms line placement [13]. A portable radiograph of the pelvis can evaluate for unstable pelvic injuries and hip dislocation [4]. There is no literature to support the use of trauma series radiographs in the detection of bowel injury. Variant 6: Major blunt trauma. Hemodynamically stable. Suspected urinary system, including urethra trauma. Initial imaging.