NEXUS Chest CT: blunt chest trauma

Trauma & imaging rules

Blunt trauma within 6 hours, age over 14, chest imaging being considered. A rule-out instrument: with no criterion present, chest CT can be avoided. A criterion present does not by itself mean CT is needed.

What you enter

Abnormal chest x-ray (any thoracic injury, including clavicle fracture, or a widened mediastinum)
Rapid deceleration mechanism (fall from >20 ft / 6.1 m, or vehicle crash at >40 mph / 64 km/h with sudden deceleration)
Distracting injury
Chest wall tenderness
Sternal tenderness
Thoracic spine tenderness
Scapular tenderness

FORMULACT-All: abnormal CXR, rapid deceleration, distracting injury, chest wall, sternal, thoracic spine or scapular tenderness. CT-Major: the same without rapid deceleration. None present rules out.

SourceRodriguez RM et al. Derivation and validation of two decision instruments for selective chest CT in blunt trauma (NEXUS Chest CT). PLoS Med 2015;12(10):e1001883ReviewedFormula and thresholds checked against the source on 2026-09-28. If the source updates, this line will say so.