**Question:** Spleenic injury is diagnosed on X-ray by –

A) Half stomach shadow
B) Obliteration of spleenic shadow
C) Rib fracture
D) Gas under diaphragm

**Correct Answer:**

**Core Concept:** Spleenic injury is a trauma-induced damage to the spleen. Diagnosis of splenic injury on X-ray involves assessing the radiological findings that indicate the presence of splenic injury.

**Why the Correct Answer is Right:**

**B) Obliteration of spleenic shadow:** Obliteration of the spleenic shadow on X-ray indicates the absence of the spleen due to injury, making it difficult to visualize the spleen. This is a key finding in diagnosing splenic injury.

**Why Each Wrong Option is Incorrect:**

**A) Half stomach shadow:** Half stomach shadow is a normal finding on X-ray and does not specifically indicate splenic injury. In fact, spleenic injury could potentially cause splenomegaly or shifting of the stomach, which may lead to misinterpretation of half stomach shadow as a normal finding.

**C) Rib fracture:** A rib fracture is a separate injury and is not directly indicative of splenic injury. While splenic injury may be associated with rib fracture, the presence of rib fracture alone is insufficient for diagnosing splenic injury.

**D) Gas under diaphragm:** Gas under the diaphragm is a finding in pneumothorax or pneumomediastinum, not specifically related to splenic injury. If present, it could be a clue for a concomitant injury, but not solely for diagnosing splenic injury.

**Clinical Pearl:** To diagnose splenic injury, X-ray findings should be combined with clinical suspicion, physical examination, and other imaging modalities like ultrasound or computed tomography (CT) scan, as X-ray alone might not be sufficient for definitive diagnosis.

**Correct Answer:** B) Obliteration of spleenic shadow

**Explanation:** In the context of splenic injury, obliteration of the spleenic shadow on X-ray refers to the absence of the spleenic shadow due to injury. This finding is specific to splenic injury and can be indicative of the injury. Combining this finding with clinical suspicion, physical examination, and other imaging modalities is essential for a definitive diagnosis of splenic injury.

**Why Each Wrong Option is Incorrect:**

A) Half stomach shadow - This is a normal finding on X-ray and does not specifically indicate splenic injury. In fact, splenic injury might cause splenomegaly or stomach shifting, which could lead to misinterpretation of half stomach shadow as normal.

C) Rib fracture - A rib fracture is an unrelated injury and is not directly indicative of splenic injury. While splenic injury could be associated with rib fracture, the presence of rib fracture alone is insufficient for diagnosing splenic injury.

D) Gas under diaphragm - Gas under the diaphragm is a finding in pneumothorax or pneumomediastinum and is not exclusively