Abstract
BackgroundUltrasound is being used increasingly to diagnose pathological free fluid accumulation at the bedside. In addition to the detection of peritoneal and pericardial fluid, point-of-care ultrasound allows rapid bedside diagnosis of pleural fluid.FindingsIn this short report, we describe the sonographic observation of the vertebral or ‘V-line’ to help confirm the presence of pleural fluid in the supine patient. The V-line sign is a result of the fluid acting as an acoustic window to enable visualization of vertebral bodies and posterior thoracic wall, thus confirming the presence of pleural fluid.ConclusionsThe V-line is a useful sonographic sign to aid the diagnosis of pleural free fluid.
Highlights
Ultrasound is being used increasingly to diagnose pathological free fluid accumulation at the bedside
The presence of pleural fluid is typically diagnosed through physical examination and plain radiography
In intensive care units (ICU) patients with co-existing lung pathology, supine Chest X-ray (CXR) have a sensitivity of 39% and specificity of 85% for detection of pleural fluid [14]
Summary
Ultrasound is being used increasingly to diagnose pathological free fluid accumulation at the bedside. Supine CXR, used in critically ill and trauma patients, is even poorer at detecting pleural effusions, being able to detect 175 to 525 mL of pleural fluid [13]. In ICU patients with co-existing lung pathology (which represents the majority of critically ill patients), supine CXRs have a sensitivity of 39% and specificity of 85% for detection of pleural fluid [14].
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