Simple question. What do these two chest x-rays have in common. No info I’m afraid.
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They are both x-rays of the same patient.
He had fallen through a roof and fractured his left humerus but was clinically quite well. The first x-ray was supine. After c-spine clearance and observation he remained very well and despite the official report of CXR 1 suggesting to get a CT thorax, we sat him up and got CXR 2 and left things be.
This illustrates the impact of projection and position on CXR findings. We would all agree that the first x-ray as a massive and concerning mediastinum and the second looks fine.
It would be wise to get a CT on these people if the clinical situation demands it, which is a slippery (but still accurate) way of saying that lots of info goes into deciding when to go looking for a mediastinal haematoma or aortic dissection.