Transthoracic US of the Chest: Clinical Uses and Applications

Koh, Dow‐Mu; Burke, Stephen; Davies, Neil M; Padley, Simon

doi:10.1148/radiographics.22.1.g02jae1e1

Cited by 173 publications

(193 citation statements)

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“…11 Although it was not utilized in the cases presented, US has been shown to be effective in the detection of pneumothorax and pleural effusions. 12 An immediate diagnosis would allow proper treatment and could avoid such pulmonary complications. 7 Prompt recognition could also avoid potential complications from local manipulative therapy.…”

Section: Discussionmentioning

confidence: 99%

Sonography of Occult Rib and Costal Cartilage Fractures: A Case Series

Mattox

Reckelhoff

Welk

et al. 2014

Journal of Chiropractic Medicine

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Objective: The purpose of this case series is to describe the use of diagnostic ultrasound (US) in the detection of occult rib and costal cartilage fractures presenting as chest wall pain to a chiropractic clinic. Clinical features: Three patients presented with chest wall pain and tenderness. Two of the patients presented with acute chest wall injury and 1 carried a previous diagnosis of rib fracture after trivial trauma 2 months earlier.Intervention and outcomes: Diagnostic US was selected as a non-ionizing imaging tool for these patients after negative digital radiography studies. All fractures were considered isolated as there was no associated injury, such as pneumothorax. Both of the acute cases were followed up to complete healing (evidence of osseous union) using US. All patients eventually achieved pain-free status. Conclusion: In these cases, US was more sensitive than radiography for diagnosing these cases of acute rib and costal cartilage fractures. Early recognition of rib injury could avoid potential complications from local manipulative therapy.

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Section: Discussionmentioning

confidence: 99%

Sonography of Occult Rib and Costal Cartilage Fractures: A Case Series

Mattox

Reckelhoff

Welk

et al. 2014

Journal of Chiropractic Medicine

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“…The frequency of diagnostic ultrasound is in the millions of Hertz (MHz) and ranges from 2 to 10 MHz for transthoracic US (8)(9)(10). The distribution and intensity of the US image on the screen is determined by three characteristics: 1) the direction and 2) intensity of the captured echoes, and 3) the time elapsed from emission to capture (8)(9)(10).…”

Section: Basics: Physics and Principlesmentioning

confidence: 99%

“…Echogenicity is the ability to reflect an echo, and the echogenicity of any tissue or lesion is defined relative to that of the normal liver, which is arbitrarily considered isoechoic (9). Sound waves propagate well though liquids (e.g., pleural effusions) and through tissues with a high fluid content (e.g., consolidated lung, tumors, and liver) (8,10,11). Tissues that have higher echogenicity are called "hyperechoic" and are usually represented with lighter colors.…”

Section: Basics: Physics and Principlesmentioning

confidence: 99%

Transthoracic Ultrasonography for Clinicians

Vorster¹,

Allwood²,

Koegelenberg³

2015

Eurasian J Pulmonol

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Transthoracic ultrasonography (US) has become an essential tool for respiratory, emergency, and critical care physicians. It can be performed with basic equipment and by personnel with minimum training as a modality for the evaluation of a wide range of thoracic pathologies. Its advantages include immediate application at the point of care, low cost, and lack of radiation. The main indications for transthoracic US are the qualitative and quantitative assessment of pleural effusions, pleural thickening, diaphragmatic pathology, as well as chest wall and pleural tumors. Transthoracic US is also useful in visualizing pulmonary pathologies that abut the pleura, such as pneumonic consolidation and interstitial syndromes, including pulmonary edema. Transthoracic US is more sensitive than the traditional chest radiograph in the detection of pneumothoraces, and it is useful in diagnosing skeletal abnormalities such as rib fractures. It is the ideal tool to guide transthoracic procedures, including thoracocentesis and pleural biopsy. Moreover, transthoracic US-guided procedures can be performed by a single clinician with no sedation and minimal monitoring. Transthoracic US-guided fine needle aspiration and/or cutting needle biopsy of extrathoracic lymph nodes and lesions arising from the chest wall, pleura, peripheral lung, and mediastinum are safe to perform and have a high yield in the of hands of experienced clinicians. Transthoracic US can also potentially guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations, and lung abscesses. Moreover, transthoracic US may be used in the detection of pulmonary embolism.

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“…The choice depends on the depth of the structure being examined. Superficial structuresd subcutaneous soft tissues, muscle tissues, and bonesdare examined with high-frequency linear transducers; pleural disease and consolidation and focal lesions of the lung parenchyma can be studied with linear or convex transducers and frequencies that range from high to low depending on the depth of the examination [5]. Transverse and longitudinal scans are used with intercostal, subcostal, supra-and parasternal, or paravertebral accesses.…”

Section: Techniquementioning

confidence: 99%

Interventional ultrasonography of the chest: Techniques and indications

Almolla

Balconi²

2011

Journal of Ultrasound

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KEYWORDSUltrasonography; Thoracic ultrasonography; Interventional ultrasonography.Abstract Thoracic ultrasonography can be used for diagnostic purposes as well as a guide for diagnostic and therapeutic interventions. When the lesion or fluid collection has been located and the patient properly positioned, the angle of the needle is identified with respect to the transducer. The insertion tract should transgress the smallest possible area of aerated parenchyma. The needle can be introduced with a free-hand technique or with the aid of a needle guide. Correct planning of the procedure reduces intervention time and decreases the risk of complications. The main indications are superficial masses that require biopsy, pleural and parenchymal lesions formerly biopsied with CT or fluoroscopic guidance, and fluid collections that need to be drained. Ultrasound, thanks to its widespread use, simple execution, and low costs, represents a safe, manageable guide for thoracic interventions.Sommario L'impiego dell'ecografia in ambito toracico, oltre all'utilità diagnostica, è quello di guida e supporto alle tecniche interventistiche, sia diagnostiche, sia terapeutiche. Individuata la lesione o la raccolta e l'idonea posizione del paziente, si pianifica la procedura, impostando l'angolo d'inclinazione dell'ago rispetto alla superficie del trasduttore, cercando di risparmiare il maggior parenchima aerato possibile. L'introduzione dell'ago può essere condotta sia a mano libera, sia mediante opportune guide. Una corretta pianificazione dell'intervento riduce i tempi di esecuzione e l'entità delle complicanze. Le principali indicazioni sono rappresentate dal prelievo bioptico di lesioni espansive superficiali cui si associano quelle in ambito pleurico e parenchimale già campo d'azione di metodiche quali la TC e precedentemente la fluoroscopia, oltre al drenaggio delle raccolte. Per l'ampia diffusione, la semplicità di esecuzione ed i bassi costi l'ecografia si pone come uno strumento sicuro e maneggevole nella guida delle procedure interventistiche in ambito toracico. ª

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Transthoracic US of the Chest: Clinical Uses and Applications

Cited by 173 publications

References 50 publications

Sonography of Occult Rib and Costal Cartilage Fractures: A Case Series

Sonography of Occult Rib and Costal Cartilage Fractures: A Case Series

Transthoracic Ultrasonography for Clinicians

Interventional ultrasonography of the chest: Techniques and indications

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