Abstract
Background Pulmonary ultrasound plays a key role in the diagnosis of pneumothorax in emergency and intensive-care medicine. The lung point sign has been generally considered a pathognomonic diagnostic sign. Recently, several other situations have been published that can mimic the lung point, as well as a few different variants of the true lung point sign. Materials and Methods Based on years of monitoring the literature and collecting our database of ultrasound findings, we prepared a review of ultrasound findings mimicking the lung point sign and ultrasound variants of the true lung point sign. Results We present four imitations of the lung point sign (physiological lung point sign, pseudo-lung point sign, bleb point sign, and pleurofascial point sign) and two variants of the true lung point sign (double lung point sign and hydro point sign) documented by images and video records. Conclusions Knowledge of ultrasound imitations and variants of the lung point sign may increase the reliability of pneumothorax diagnosis and may reduce the risk of performing unindicated interventions.
Highlights
Detection of pneumothorax is one of the typical examples of the effective use of bedside Point-of-Care Ultrasound (POCUS) in emergency medicine
Ultrasonographic diagnosis of pneumothorax was first described in veterinary medicine in horses and immediately implemented in human medicine [1, 2]
Zhang and Chen introduced an imitation of the lung point sign and called it physiological lung point sign. ey observed that applying the probe longitudinally at the 4th-5th intercostal space parasternally, it is possible to display, at the site of the mediastinal pleura, a tissue interface that is bounded by mediastinal tissue with the absence of pleural sliding and by a normally aerated lung with pleural sliding [10]
Summary
Pulmonary ultrasound plays a key role in the diagnosis of pneumothorax in emergency and intensive-care medicine. e lung point sign has been generally considered a pathognomonic diagnostic sign. Pulmonary ultrasound plays a key role in the diagnosis of pneumothorax in emergency and intensive-care medicine. E lung point sign has been generally considered a pathognomonic diagnostic sign. Several other situations have been published that can mimic the lung point, as well as a few different variants of the true lung point sign. Based on years of monitoring the literature and collecting our database of ultrasound findings, we prepared a review of ultrasound findings mimicking the lung point sign and ultrasound variants of the true lung point sign. Knowledge of ultrasound imitations and variants of the lung point sign may increase the reliability of pneumothorax diagnosis and may reduce the risk of performing unindicated interventions
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