In a pelvic ring fracture on CT, which finding is the most specific predictor of major arterial haemorrhage requiring angioembolisation?
- A Disruption of the posterior sacroiliac complex
- B Active contrast extravasation (blush) on arterial phase CT ✓
- C Presence of retroperitoneal haematoma
- D Pubic symphysis diastasis > 2.5 cm
Correct answer: B. Active contrast extravasation (blush) on arterial phase CT
Explanation
An arterial blush (active contrast extravasation) on contrast-enhanced CT is the most specific predictor of ongoing arterial haemorrhage and is a direct indication for emergent angiography and embolisation. Retroperitoneal haematoma may arise from venous or bony bleeding and is less specific. Posterior SI complex disruption correlates with injury severity and higher transfusion requirements but does not specifically indicate arterial injury. Symphysis diastasis indicates instability without directly predicting arterial injury.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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