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Lung ultrasound can rapidly identify pneumothorax at the bedside using findings such as absence of lung sliding, B-lines and the lung point. Meta-analyses comparing lung ultrasound with chest radiography and CT have found high sensitivity and specificity, particularly when an experienced operator uses a standardized examination. For internists working in emergency and acute-care settings, the advantage is speed: ultrasound can be performed during the initial assessment without moving an unstable patient. The technique is also repeatable and can be integrated with cardiac and venous ultrasound. However, false positives can occur when pleural sliding is reduced for other reasons, and a negative scan should be interpreted in the context of pre-test probability and technical adequacy. Training should therefore focus on artifacts and pattern recognition rather than memorizing isolated signs. The evidence supports lung ultrasound as a practical bedside adjunct that can accelerate evaluation while preserving the role of radiography or CT when definitive imaging is needed.
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Lung ultrasound can rapidly identify pneumothorax at the bedside using findings such as absence of lung sliding, B-lines and the lung point. Meta-analyses comparing lung ultrasound with chest radiography and CT have found high sensitivity and specificity, particularly when an experienced operator uses a standardized examination. For internists working in emergency and acute-care settings, the advantage is speed: ultrasound can be performed during the initial assessment without moving an unstable patient. The technique is also repeatable and can be integrated with cardiac and venous ultrasound. However, false positives can occur when pleural sliding is reduced for other reasons, and a negative scan should be interpreted in the context of pre-test probability and technical adequacy. Training should therefore focus on artifacts and pattern recognition rather than memorizing isolated signs. The evidence supports lung ultrasound as a practical bedside adjunct that can accelerate evaluation while preserving the role of radiography or CT when definitive imaging is needed.
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