UMEM Educational Pearls

Title: What's the Diagnosis? The Critical Care Edition

Posted: 12/15/2015 by Haney Mallemat, MD
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Question

A patient arrives in acute respiratory distress with left sided chest pain. Ultrasound of the left anterior chest is shown; what's the diagnosis and name one false positive?

Answer

Lung point indicating pneumothorax (PTX)....see below for the false positives

What's the (Lung) Point

Separation of the visceral and parietal pleural secondary to a PTX leads to well recognized loss of lung sliding on ultrasound.
Lung point (LP) on ultrasound is where the transition between pleural sliding and the loss of this sliding is demonstrated. Previous studies have reported that the LP has 100% specificity for a PTX.
Although this is a great sign to demonstrate PTX, be aware that there are several LP mimics:
- lung-heart interface
- lung-diaphragm interface (lower thorax laterally)
- pleural effusion
- blebs
Check out these great #FOAM posts by @ultrasoundjelly & @ultrasoundMD for more on the LP (and their mimics). Check them out here & here

References

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