45 year old male presents with left sided chest pain after scuba diving. What does the ultrasound show?
This clip shows a very small anterior pneumothorax
Look at the bright pleural line lying horizontally just deep to the two ribs. Follow the pleural line to the right, and cardiac and mediastinal movement can be seen. Follow the pleural line to the left, and lung sliding and a lung point are seen.
Between the normal lung sliding and the repetitive cardiac movement is an area of still parietal pleura. Here lung sliding is lost, and deeper A-lines can be briefly demonstrated, but are interrupted repetitively by intervening cardiac pulsations.
A small pneumothorax is present below the transducer, but it is hidden briefly every cardiac cycle as the heart pushes against the parietal pleural surface displacing the pneumothorax out of view.
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An Emergency physician based in Perth, Western Australia. Professionally my passion lies in integrating advanced diagnostic and procedural ultrasound into clinical assessment and management of the undifferentiated patient. Sharing hard fought knowledge with innovative educational techniques to ensure knowledge translation and dissemination is my goal. Family, wild coastlines, native forests, and tinkering in the shed fills the rest of my contented time. | SonoCPD | Ultrasound library | Top 100 | @thesonocave |