Fig 1. A 3D reconstruction from a CT scan showing a flail chest via Wikimedia

Identification is by palpation as well as inspection.

A CXR might identify associated pneumothorax, haemothorax and pulmonary contusions (see the image below – click for a larger version). The appearance of early pulmonary contusions is particularly worrying, and evidence of further and perhaps more extensive contusions with physiological effect may evolve.

Fig 2: Pulmonary contusions