page_title: Pulmonary contusion
section_title: X-ray
hierarchical_section_title: Pulmonary contusion / Diagnosis / X-ray
caption_attribution_description: Chest X-ray of a pulmonary contusion
context_page_description: A pulmonary contusion, also known as lung contusion, is a bruise of the lung, caused by chest trauma. As a result of damage to capillaries, blood and other fluids accumulate in the lung tissue. The excess fluid interferes with gas exchange, potentially leading to inadequate oxygen levels. Unlike pulmonary laceration, another type of lung injury, pulmonary contusion does not involve a cut or tear of the lung tissue.
  A pulmonary contusion is usually caused directly by blunt trauma but can also result from explosion injuries or a shock wave associated with penetrating trauma. With the use of explosives during World Wars I and II, pulmonary contusion resulting from blasts gained recognition. In the 1960s its occurrence in civilians began to receive wider recognition, in which cases it is usually caused by traffic accidents. The use of seat belts and airbags reduces the risk to vehicle occupants.
  Diagnosis is made by studying the cause of the injury, physical examination and chest radiography.
context_section_description: Chest X-ray is the most common method used for diagnosis, and may be used to confirm a diagnosis already made using clinical signs.  Consolidated areas appear white on an X-ray film.  Contusion is not typically restricted by the anatomical boundaries of the lobes or segments of the lung.  The X-ray appearance of pulmonary contusion is similar to that of aspiration, and the presence of hemothorax or pneumothorax may obscure the contusion on a radiograph. Signs of contusion that progress after 48 hours post-injury are likely to be actually due to aspiration, pneumonia, or ARDS.
  Although chest radiography is an important part of the diagnosis, it is often not sensitive enough to detect the condition early after the injury. In a third of cases, pulmonary contusion is not visible on the first chest radiograph performed. It takes an average of six hours for the characteristic white regions to show up on a chest X-ray, and the contusion may not become apparent for 48 hours. When a pulmonary contusion is apparent in an X-ray, it suggests that the trauma to the chest was severe and that a CT scan might reveal other injuries that were missed with X-ray.
caption: A chest X-ray showing right sided (seen on the left of the picture) pulmonary contusion associated with rib fractures and subcutaneous emphysema
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