January 10, 2012

Pneumothorax on Ultrasound

M-mode ultrasound images of the lungs (right and left) show a normal "lung sliding" on the right side "Right" and absence of it on the left side "Left".

  • Ultrasound can be performed to diagnose pneumothorax with high accuracy
  • Normal "lung sliding" is seen when pleura moves against the chest wall during respiration. The movement is easily seen on real-time imaging and can be captured on M-mode ultrasound
  • M-mode US shows normal lung sliding as a "seashore sign", in which the motion of pleura/lung produces sand-like granular appearance on the image. The non-mobile chest wall shows several uninterrupted band or "sea"
  • Some diseases may produce "loss of lung sliding", most notably pneumothorax
Pneumothorax on US
  • Absence of lung sliding shown on real-time imaging
  • On M-mode as "barcode sign" or "stratosphere sign" (see above image labeled "left")
  • More specific sign is the "lung point sign"
Our case: left pneumothorax (confirmed with radiography)

Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Chest 1995; 108:1345-48.

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