Limited Chest - Pneumothorax

 

Sonographic signs of pneumothorax (1,2)

  • B-Mode - Loss of pleural sliding

  • B-Mode - Presence of a lung point sign 

  • B-Mode - Absence of B-lines

  • M-Mode - Presence of a Barcode sign (a.k.a. stratosphere sign)

 

Potential False Positives (3-7)

  • Main Stem Intubation

  • Lung bullae, contusions, adhesions

  • Severe COPD

  • Pleurodesis

  • Pneumonectomy

 

Literature Review by JUSTIN YAWORSKY

 

 

 

NORMAL VS PTX

 

LUNG POINT

 

 

NORMAL PLEURAL SLIDE VS PNEUMOTHORAX

 

References

  1. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for the International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577–91. doi: 10.1007/s00134-012-2513-4.

  2. Gurung P, Doelken P. Chapter 7. Thoracic Ultrasound. In: Carmody KA, Moore CL, Feller-Kopman D. eds. Handbook of Critical Care and Emergency Ultrasound. New York, NY: McGraw-Hill; 2011. 

  3. Bahner D, Blaivas M, Cohen HL, et al. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med Off, J Am Inst Ultrasound Med. 2008;27(2):313–8.

  4. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International Liaison Committee on Lung Ultrasound (ILC-LUS) for the International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med. 2012;38:577–91. doi: 10.1007/s00134-012-2513-4.

  5. Bahner D, Blaivas M, Cohen HL, et al. AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. J Ultrasound Med Off, J Am Inst Ultrasound Med. 2008;27(2):313–8.

  6. Gurung P, Doelken P. Chapter 7. Thoracic Ultrasound. In: Carmody KA, Moore CL, Feller-Kopman D. eds. Handbook of Critical Care and Emergency Ultrasound. New York, NY: McGraw-Hill; 2011. 

  7. Sperandeo M, Varriale A, Sperandeo G, et al. Characterization of the normal pulmonary surface and pneumonectomy space by reflected ultrasound. Journal of Ultrasound. 2011;14(1):22-27. doi:10.1016/j.jus.2011.01.004.

 

 

PAGE AUTHORS

JUSTIN YAWORSKY, MD CANDIDATE CLASS OF 2020

MATT JONES, MD, MS, RDMS, RDCS

CODY MCILVAIN, MD CANDIDATE CLASS OF 2020

SEAN WHITTY, MD CANDIDATE CLASS OF 2020

 

CONSULTING SPECIALIST

DON BYARS, MD, RDMS, RDCS

SEAN CALLAHAN, MD (PULMONARY AND CRITICAL CARE)

 

IMAGE CONTRIBUTORS

MATT JONES, MD, MS, RDMS, RDCS

GIORGI TSEREDIANI, MD

LOGAN MCNEIVE, MD

CODY MCILVAIN, MD CANDIDATE CLASS OF 2020

JUSTIN YAWORSKY, MD CANDIDATE CLASS OF 2020

D. TAYLOR GAMMONS, MD

JOSHUA FOX, PA-C

Peter Brooks, MD