NDLI: Should bedside sonography be used first to diagnose pneumothorax secondary to blunt trauma?

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Should bedside sonography be used first to diagnose pneumothorax secondary to blunt trauma?

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Should bedside sonography be used first to diagnose pneumothorax secondary to blunt trauma?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Donmez, Halil Tokmak, Turgut Tursem Yildirim, Afra Buyukoglan, Hakan Ozturk, Mehmet Yasar Ayaz, Umit Mavili, Ertugrul
Description	Country affiliation: Turkey Author Affiliation: Donmez H ( Erciyes University, Department of Radiology, Kayseri, Turkey.)
Abstract	BACKGROUND.: Our purpose was to evaluate the effectiveness of bedside sonography (US) in the detection of pneumothorax secondary to blunt thoracic trauma. METHODS.: In this prospective study, 240 hemithoraces of 120 consecutive patients with multiple trauma were evaluated with chest radiographs (CXR) and bedside thoracic US for the diagnosis of pneumothorax. CT examinations were performed in 68 patients. Fifty-two patients who did not undergo CT examinations were excluded from the study. US examinations were performed independently at bedside by two radiologists who were not informed about CXR and CT findings. CXRs were interpreted by two radiologists who were unaware of the US and CT results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CXR and US were calculated. RESULTS.: One hundred thirty-six hemithoraces were assessed in 68 patients. A total of 35 pneumothoraces were detected in 33 patients. On US, the diagnosis of pneumothorax was correct in 32 hemithoraces. In 98 hemithoraces without pneumothorax, US was normal. With US examination, there were three false-positive and three false-negative results. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of US were 91.4%, 97%, 91.4%, 97%, and 97%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CXR were 82.7%, 89.7%, 68.5%, 95%, and 89.5%, respectively. CONCLUSIONS.: Bedside thoracic US is an accurate method that can be used in trauma patients instead of CXR for the detection of pneumothorax.
File Format	HTM / HTML
ISSN	00912751
Issue Number	3
Volume Number	40
e-ISSN	10970096
Journal	Journal of Clinical Ultrasound
Language	English
Publisher	Wiley
Publisher Date	2012-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Diagnostic Imaging Pneumothorax Etiology Point-of-care Systems Wounds, Nonpenetrating Complications Humans Multiple Trauma Observer Variation Predictive Value Of Tests Prospective Studies Reproducibility Of Results Sensitivity And Specificity Thorax Ultrasonography Journal Article
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging

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