Pattern Recognition: A Mechanism-based Approach to Injury Detection after Motor Vehicle Collisions

Motor vehicle collisions cause substantial mortality, morbidity, and expense worldwide. Certain types of injuries are more likely to result from frontal versus side-impact collisions, and knowledge of these specific patterns and why they occur aids in accurate and efficient diagnosis of traumatic injuries. Although the proper use of seat belts decreases crash-related mortality during frontal impact, certain injury patterns to the torso are directly attributed to restraint use. The spectrum of seat belt-related injuries ranges from mild skin and soft-tissue contusions to traumatic bowel injuries and unstable spine injuries that require surgery. Impact with the steering wheel or windshield during a frontal crash can cause characteristic injuries to the head, neck, torso, and distal upper extremity. Steering wheel deformity is an independent predictor of serious thoracic and abdominal injury among front-seat passengers. Impact of a flexed knee with the dashboard during a frontal collision can cause knee, thigh, and hip injuries. Distal lower extremity injuries are encountered frequently when the floorboard is driven into the foot. Lateral impact crashes often result in traumatic brain, thoracic, abdominal, and pelvic injuries, which are more often fatal to occupants on the side of the impact. The specific mechanism-based injury patterns are reviewed to establish a structured systematic search pattern that enables the radiologist to identify traumatic injuries with greater accuracy and speed, thereby improving the care of patients who experience acute trauma. © RSNA, 2019 See discussion on this article by Ballard and Mellnick .