Evaluating the multiply injured patient radiographically

Abstract

In the multiply injured patient there are obvious lesions that often overshadow other lesions, creating a significant possibility that they will be overlooked. Because of the high incidence of missed lesions in such patients, it is a good idea to approach the patient with the presumption that one may be overlooking something and ask oneself what other lesions may be associated with the known lesions. We have enumerated several injuries that frequently occur together and have called them clinical dyads. It is hoped that knowledge of the associations will prevent oversight of the second lesion. The radiographic examination serves as an extension of the physical examination, confirming clinical suspicions and documenting the extent of many injuries. We have outlined what we believe is a prudent radiographic examination in a multiply injured patient. It provides information about the areas most likely to have injuries but is not so extensive that it hinders patient care. It is a starting place or survey and may lead to other, more complicated radiographic studies should the findings warrant them.