Radiology Review

From Revved Up to Banged Up

Author and Disclosure Information

From Revved Up to Banged Up image

A man, approximately 60 years old, is brought to your facility as a trauma code following a vehicular accident. He was riding a motorcycle when he crashed into another vehicle and was thrown off. Emergency medical personnel report that the patient has obvious head, facial, and extremity trauma. Due to decreased level of consciousness, he was intubated en route. History is otherwise unknown.

Upon arrival, he has two large-bore IVs in place, with fluids going wide open. Despite that, his systolic blood pressure is 90 mm Hg and his heart rate is in the range of 150-160 beats/min. The massive transfusion protocol has been initiated to aid in the aggressive resuscitation efforts.

Portable radiographs of the chest and pelvis are obtained; the latter is shown. What is your impression?


From Revved Up to Banged Up image


There is significant diastasis of the pubic symphysis, measuring nearly 4 cm. No obvious fractures of the hip or pelvis are seen, but there is mal­alignment of the rami. There is also evidence of a proximal right femur fracture, although this area is not fully imaged.

Such radiographic findings are typically referred to as an open book pelvic fracture. Usually the result of a shear injury, these fractures are not uncommon and carry an increased risk for pelvic vascular ­injury.

Emergent orthopedic and vascular consults were obtained, and the patient was placed in a pelvic binder to help reduce the distraction and tamponade any potential vascular injuries.

Recommended Reading

The Man With No Medical History
Clinician Reviews

Related Articles

  • Radiology Review

    The Man With No Medical History

    Following a motor vehicle collision, a 60-year-old man has pain in his chest, head, and arm. He has no reported medical history; is his pain a...

  • Radiology Review

    Woman’s Weakness is Worsening

    A 65-year-old woman has been experiencing left-side weakness for mroe than two months, and she reports that it's worsening with time. Find out...

  • Radiology Review

    The Signs That Can’t Be Ignored

    Black, tarry stools; episodic hemoptysis ... what do these symptoms signify about this 60-year-old man's health and well-being? A radiograph of...