Detection of pneumothorax by accident and emergency officers and radiologists on single chest films.
To assess whether an accurate diagnosis of pneumothorax can be made on a single chest film, 233 pairs of inspiratory (I) and expiratory (E) chest films taken in an accident and emergency (A&E) department for suspected pneumothorax were reviewed by two A&E officers and three radiologists. The films were assessed for the presence of pneumothorax by viewing the I film in isolation and, after an interval, by viewing the paired I and E films together. Fifty-four of the patients had a pneumothorax. The five observers missed 23 pneumothoraces (8.5% of total) on the I film alone which were correctly diagnosed on the paired I and E films, the three radiologists missed 10/162 pneumothoraces on the I film alone which were correctly identified on the I and E films (6%) and the two A&E officers 13/108 (12.5%). The use of a single inspiratory chest film for suspected pneumothorax could result in pneumothoraces being missed, particularly by less experienced observers and therefore we believe that paired I and E films should continue to be used routinely for suspected pneumothorax.
Aitchison
F
F
Department of Radiology, Glasgow Royal Infirmary, Alexandra Parade.
Bleetman
A
A
Munro
P
P
McCarter
D
D
Reid
A W
AW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D010348:Patient Care Team; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D011785:Quality Assurance, Health Care; D011859:Radiography