Describe the spectrum of blast injuries. Understand the emergent radiologic evaluation of penetrating injuries.
Insurgent conflicts and terrorist attacks present new challenges in warfare. The frequent use of IED's (improvised explosive devices) coupled with the use of body and vehicle armor has created new patterns of injury. Penetrating material typically shows an upward oblique trajectory through the neck region. Blast and shockwave injuries cause chest wall and pulmonary contusions. In theater, there is graduated evalaution and treatment of casualties: battle aid station; CASH units; and, evacuation to tertiary hospital care. We will present a spectrum of these injuries and discuss both the initial imaging and management with plain films, as well as the followup and definitive repair guided by CT and MR. General and Trauma radiologists should be familiar with these new patterns of injury.