The precise method for measuring mediastinal widening in thoracic trauma is poorly understood and too much emphasis is placed on it as the sole criterion for performing aortography. This review article describes the established methods of measurement and their limitations, and also discusses the importance of other signs pointing to aortic rupture such as blurring of the aortic knuckle and a subjective impression of mediastinal abnormality which are more helpful in determining the need for angiography.

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