Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients

Table 1 Thoracic ultrasound - main indications

The physical examination by a non-radiologist MD can be usefully completed by a thorough and fast chest exploration. The aims are

To clarify symptoms already known (dyspnea, chest pain, fever, cough) or detected signs, such as rales, crackles or dullness

To detect unexpected chest abnormalities such as pleural effusion or lung consolidation in subjects with few or no evident respiratory symptom

Information and clues derived by TUS may focus better to further diagnostic definition, by radiology or by other procedures, avoiding time-wasting and even detrimental choices

The detection of pneumothorax by TUS is a quite simple and direct diagnosis of a not rare condition (see below), which should be usefully addressed to radiology, often including CT, for confirm. TUS has the great merit of making possible this direct pathway avoiding or postponing the more usual steps of chest pain work-up: Cardiological and laboratory investigations and preventive pharmacological drugs

In addition, the detection of subpleural infiltrates after a blunt thoracic trauma, apparently relatively uneventful, can address to a subsequent better focused diagnostic workup

Signs and symptoms initially addressing to different organs or body areas

Upper abdominal pain, easily attributable to gallbladder

Lumbar-flank pain, usually attributable to kidneys or spine, should prompt also to a TUS examination, since, with or without fever, the detection of pleural effusion or of downward areas of lung consolidation may address, as not infrequently happens, to a different diagnosis

TUS: Thoracic ultrasound; MD: Medical doctors; CT: Computerized tomography.