ARRS 2022: Updated Primer on Imaging Ballistic Injuries

An award-winning Electronic Exhibit at the 2022 ARRS Annual Meeting guides radiologists’ interpretation of ballistic trauma and injury patterns by helping them understand the most recent mechanisms of both direct and indirect injury caused by a bullet and the shockwave around its path.

“When interpreting imaging, one should use a mechanistic approach to establish bullet trajectory followed by assessment for injuries along the established path. Retained bullet fragments should be considered MRI conditional, and with the appropriate preceding workup patients, may be safely imaged,” wrote Jaykumar Nair, Submitting and First Author, from St. Michael's Hospital and University of Toronto in Ontario, Canada.

Moreover, these updates point out key anatomic and pathophysiologic issues, as well as imaging findings and techniques, of firearms and ballistics tissue injuries. Specifically, ballistic injury is a combination of blunt and penetrating injuries. Knowing the bullet trajectory can help detect injuries along its path, including the temporary and permanent cavities.

In addition to helping radiologist understand the basics of firearms and ballistics, the exhibit also provided insight into MRI safety in patients with retained ballistic debris.