Figure 4

Plain supine AP chest radiograph showing extensive surgical emphysema; multitude of rib fractures and flail on the left side; bilateral pulmonary contusions and suggestion of a haemothorax on the left side; a rotated 'boot shaped' cardiac silhouette, with clear demarcation of cardiac silhouette from the diaphragm; pneumomediastinum; the pericardial contour is also distinctly visible; endotracheal tube.