Prospective evaluation of thoracic ultrasound in the detection of pneumothorax.
BACKGROUND
Thoracic ultrasound may rapidly diagnose pneumothorax when radiographs are unobtainable; the accuracy is not known.


METHODS
We prospectively evaluated thoracic ultrasound detection of pneumothorax in patients at high suspicion of pneumothorax. The presence of "lung sliding" or "comet tail" artifacts were determined in patients by ultrasound before radiologic verification of pneumothorax by residents instructed in thoracic ultrasound. Results were compared with standard radiography.


RESULTS
There were 382 patients enrolled; the cause of injury was blunt (281 of 382), gunshot wound (22 of 382), stab wound (61 of 382), and spontaneous (18 of 382). Pneumothorax was demonstrated on chest radiograph in 39 patients and confirmed by ultrasound in 37 of 39 patients (95% sensitivity); two pneumothoraces could not be diagnosed because of subcutaneous air; the true-negative rate was 100%.


CONCLUSIONS
Thoracic ultrasound reliably diagnoses pneumothorax. Expansion of the focused abdominal sonography for trauma (FAST) examination to include the thorax should be investigated for terrestrial and space medical applications.
Department of Surgery, Wayne State University School of Medicine, 4201 St. Antoine, Detroit, MI 48201, USA.
S A
SA
Dulchavsky
K L
KL
Schwarz
A W
AW
Kirkpatrick
R D
RD
Billica
D R
DR
Williams
L N
LN
Diebel
M R
MR
Campbell
A E
AE
Sargysan
D R
DR
Hamilton
D006801:Humans; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D014951:Wounds, Stab / Q000000981:diagnostic imaging