Pneumothorax Case 3

A 31 year old male presents after what is thought to be a superficial penetrating chest wound. You perform an ultrasound.

What does the ultrasound demonstrate?

Reveal Answer
  • A pneumothorax is present.
  • Chest wall movement can be seen with each breath, with the intercostal muscles rising and falling.
  • Despite chest wall movement there is no lung sliding, no short path reverberation artefacts (the echogenic vertical artefacts known as B-lines and comet tail artefacts in lung), and the long path reverberation artefacts (the bright horizontal repetitive artefacts known as A-lines in lung) are accentuated and still.
  • The parietal pleural surface with the free air deep to it acts as a mirror and the tissues superficial to the pleural line can be seen reflected below.

You perform an ultrasound scan on the contralateral side of the chest. What does the ultrasound demonstrate?

View 2
Reveal Answer
  • This is the uninjured side of the chest.
  • This demonstrates normal lung sliding; a comet tail artefact and much more subtle, constantly interrupted A-lines.

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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. | SonoCPDUltrasound library | Top 100 | @thesonocave |

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