Which chest radiograph finding is expected with rib fractures and lung compression?

• A. Increased opacity/density from lung compression and rib fractures
• B. Hyperinflation of the lung
• C. Clear bilateral lungs
• D. Widened mediastinum

Answer: (A)

When the chest wall is injured from rib fractures, the nearby lung tissue is often compressed and may become contused. This combination leads to increased density on a chest radiograph in the affected region. The swelling and shallow breathing that accompany chest pain promote atelectasis, while the contusion/hemorrhage in the lung adds to the opacity. So the expected finding is a localized area of increased opacity or density where the rib fractures occurred, reflecting both lung compression (atelectasis) and contusion.

Hyperinflation would not fit this scenario because rib fractures with lung compression typically reduce lung volume rather than expand it. Clear bilateral lungs would suggest no injury to the lungs at all, which contradicts the presence of rib fractures with compression. A widened mediastinum points to injuries of central thoracic structures rather than a consequence of rib fractures with lung compression.