Diagnosis of Thoracic Trauma Clinical evaluation Chest x-ray Sometimes other imaging studies (eg, CT, ultrasonography, aortic imaging studies) Clinical evaluation Five conditions are immediately life threatening and rapidly correctable: Massive hemothorax Tension pneumothorax Open pneumothorax Flail chest Pericardial tamponade Diagnosis and treatment begin during the primary survey (see Approach to the Trauma Patient) and are based first on clinical findings.