Pneumothorax

Detection of a pneumothorax has been only recently described with a probe of higher frequency (7.5-10Mhz, linear) that examines movement of the pleural. During normal respiration, the visceral pleura slides against the parietal pleura and movement of the air/tissue interfaces is seen as comet-tail artefacts on ultrasound.

In the presence of a pneumothorax, there is loss of both lung sliding and comet-tail artefacts. Preliminary studies suggest that ultrasound can be very accurate in the detection of pneumothoraces. The case below illustrates a victim of blunt trauma with left sided pleuritic chest pain and dyspnoea but no evidence of pneumothorax on the plain chest X-ray. However ultrasound suggested the presence of a left sided pneumothorax, which was confirmed on a subsequent CT scan performed primarily to investigate the widened mediastinum.

		AP Chest X-ray no pneumothorax
Right chest ultrasound		CT Scan		Left Chest ultrasound

The utility and application of thoracic ultrasound for pneumothorax has yet to be established.