Dataset Information

Unusual new signs of pneumothorax at lung ultrasound.

ABSTRACT:

Background

The diagnosis of pneumothorax with a bedside lung ultrasound is a powerful methodology. The conventional lung ultrasound examination consists of a step-by-step procedure targeted towards the detection of four classic ultrasound signs, the lung sliding, the B lines, the lung point and the lung pulse. In most cases, a combination of these signs allows a safe diagnosis of pneumothorax. However, the widespread application of sonographic methodology in clinical practice has brought out unusual cases which raise new sonographic signs. The purpose of this article was to introduce some of these new signs that are described after the analysis of unusual and complex cases encountered during the clinical daily practice in an emergency department.

Findings

The double lung point consists of the alternating patterns of sliding and non-sliding lung intermittently appearing at the two opposite sides of the scan. The septate pneumothorax allows B lines and lung pulse to be still visible in a condition of pneumothorax with absent sliding. In hydropneumothorax, the air/fluid border is imaged by lung ultrasound as the interposition between an anechoic space and a non-sliding A-pattern, a sign that may be named hydro-point.

Conclusions

In bedside lung ultrasound, the operator should be aware and interpret double lung point, septate pneumothorax and hydro-point. The conventional diagnostic protocol of bedside lung ultrasound for pneumothorax should be occasionally adapted to such complex cases.

SUBMITTER: Volpicelli G

PROVIDER: S-EPMC3923561 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Publications

Unusual new signs of pneumothorax at lung ultrasound.

Volpicelli Giovanni G Boero Enrico E Stefanone Valerio V Storti Enrico E

Critical ultrasound journal 20131219 1

<h4>Background</h4>The diagnosis of pneumothorax with a bedside lung ultrasound is a powerful methodology. The conventional lung ultrasound examination consists of a step-by-step procedure targeted towards the detection of four classic ultrasound signs, the lung sliding, the B lines, the lung point and the lung pulse. In most cases, a combination of these signs allows a safe diagnosis of pneumothorax. However, the widespread application of sonographic methodology in clinical practice has brought ...[more]

PMID: 24355346

Similar Datasets

Project description:Pneumothorax is typically ruled out sonographically by detecting a glide sign, lung pulse, and/or B lines, and ruled in by detecting the return of a glide sign and/or presence of a lung point. This case series describes novel lung ultrasound findings (abnormal curtain signs) in dogs with naturally-occurring pneumothorax. This case series also describes a novel lung ultrasound protocol that involves evaluating the curtain sign along the entire thoracoabdominal border and evaluating the ventral pleural space with the probe parallel to the ribs. Six dogs with pneumothorax (three traumatic pneumothorax and three spontaneous pneumothorax) had lung ultrasound performed. All dogs had normal synchronous curtain signs in the caudal mid-to-ventral region of the thorax and abnormal curtain signs in the caudal mid-to-dorsal thoracic regions. Five dogs had bilateral pneumothorax; four had a lung point and absence of a glide sign bilaterally, and one had a lung point identified unilaterally (a lung point was not visible on the opposite side and the glide sign was equivocal bilaterally). One dog had a unilateral pneumothorax, in which a lung point and absence of a glide sign were identified. With the probe parallel to the ribs in the ventral thorax, a small volume pleural effusion was also identified in two dogs. All dogs had mild to moderate quantities of pleural air removed via thoracentesis or chest tubes following lung ultrasound. Two distinct types of abnormal curtain sign were observed, referred to as the asynchronous curtain sign and the double curtain sign. The authors hypothesize that these abnormal curtain signs are caused by the presence of free air within and/or cranial to the costophrenic recess. To the authors' knowledge, this is the first description of pneumothorax-induced abnormal curtain signs, and the first report of evaluating the curtain sign to diagnose pneumothorax in any species. Further research is required to determine the sensitivity and specificity of asynchronous and double curtain signs in diagnosing pneumothorax, and to investigate whether probe orientation parallel to the ribs in the ventral thorax will improve detection of pleural effusion.

Dataset Information

Unusual new signs of pneumothorax at lung ultrasound.

Background

Findings

Conclusions

Publications

Unusual new signs of pneumothorax at lung ultrasound.

Similar Datasets

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