Injuries in polytraumatized patients. Diagnostic imaging of the thorax and abdomen

Multisclice computed tomography (MSCT) has become the mainstay of diagnostic imaging in the multiply injured patient. In the hands of a well-trained trauma radiologist standardized CT scanning of the head and neck, chest, and abdomen with intravenous contrast and reconstructions can diagnose most life-threatening injuries and thus guide specific treatment. Such reliance on CT diagnosis requires certain logistic and building conditions as well as good communications within an interdisciplinary team.The role of traditional radiography has recently been drastically reduced at major trauma centers. At most chest radiography may be indicated if the time to acquire a CT image is too long. After CT scanning radiography of the extremities may be performed depending on clinical evidence of fractures. Ultrasonography of the shock/trauma area should only be used to look for free fluid in the abdomen in unstable patients, who may be directed straight to the operating room based on this finding. There is no diagnostic value in angiography, but angiography may, under certain circumstances, be used therapeutically, for example for embolization of retroperitoneal bleeders.