Research Article

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

  1. Halil Donmez MD1,
  2. Turgut Tursem Tokmak MD1,
  3. Afra Yildirim MD1,
  4. Hakan Buyukoglan MD2,
  5. Mehmet Ozturk MD1,
  6. Ümit Yaşar Ayaz MD3,
  7. Ertugrul Mavili MD1,*

Article first published online: 4 FEB 2012

DOI: 10.1002/jcu.21884

Issue

Journal of Clinical Ultrasound

Journal of Clinical Ultrasound

Volume 40, Issue 3, pages 142–146, March/April 2012

Additional Information

How to Cite

Donmez, H., Tokmak, T. T., Yildirim, A., Buyukoglan, H., Ozturk, M., Yaşar Ayaz, Ü. and Mavili, E. (2012), Should bedside sonography be used first to diagnose pneumothorax secondary to blunt trauma?. J. Clin. Ultrasound, 40: 142–146. doi: 10.1002/jcu.21884

Author Information

  1. 1

    Erciyes University Medical Faculty, Department of Radiology, 38039, Kayseri, Turkey

  2. 2

    Erciyes University Medical Faculty, Department of Pulmonology, 38039, Kayseri, Turkey

  3. 3

    Mersin Women's and Children's Hospital, Department of Radiology, Mersin, Turkey

*Erciyes University Medical Faculty, Department of Radiology, 38039, Kayseri, Turkey

Publication History

  1. Issue published online: 6 MAR 2012
  2. Article first published online: 4 FEB 2012
  3. Manuscript Accepted: 12 DEC 2011
  4. Manuscript Received: 10 JAN 2011

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Keywords:

  • thorax;
  • pneumothorax;
  • ultrasound;
  • pleura;
  • lung

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. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2012

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