In cases of suspected aortic injury, what should be the initial imaging step if a traumatic chest injury is assessed?

In cases of suspected aortic injury following a traumatic chest injury, the first-line imaging modality is a CT scan of the chest. This imaging technique is preferred because it allows for rapid and detailed evaluation of the thoracic structures, including the aorta, and is highly sensitive in detecting aortic injury, such as lacerations or hematomas.

The multi-detector CT scan provides comprehensive information about the chest and can identify associated injuries in nearby structures, which is crucial in trauma settings. When considering trauma management, it is vital to utilize an imaging method that can quickly and accurately guide treatment decisions, especially given the potentially life-threatening nature of aortic injuries.

Other imaging methods such as contrast angiography or an X-ray of the cervical spine may be utilized in specific scenarios but are not the initial preferred choices for confirming a suspected aortic injury after chest trauma. Contrast angiography is generally reserved for cases where there is a need for interventional management. An abdominal CT scan would not adequately assess thoracic lesions, nor does a cervical spine X-ray provide relevant information regarding aortic injuries. Hence, the CT scan of the chest is the optimal starting point for evaluation in this situation.