Pneumothorax - Imaging Protocol
Imaging Protocol
Imaging Protocol:
Given the complexity of the pneumothorax studies and the imbalance of sensitivity versus specificity of the individual signs, several algorithms have had been proposed.
This logic behind this protocol is to RULE OUT pneumothorax - not ruling in. The reason is that there is only one sign that can reliably rule in a pneumothorax yet it is quite insensitive.
As a result, the algorithm is organized in a descending order for Sensitivity, then ending with the test with the Best Specificity.
This logic behind this protocol is to RULE OUT pneumothorax - not ruling in. The reason is that there is only one sign that can reliably rule in a pneumothorax yet it is quite insensitive.
As a result, the algorithm is organized in a descending order for Sensitivity, then ending with the test with the Best Specificity.
However, some experts, now, advocate that having only one of the three signs (Lung Sliding, Lung Pulse, B-Lines) being absent does not suffice to rule out a pneumothorax. They advocate that you can only rule out a pneumothorax only if ALL THREE signs are absent simultaneously.
Take Home Messages:
- Focus on looking for the signs that will rule out a pneumothorax rather than looking for the insensitive sign (Lung Point) that rules it in
- Have a Systematic Approach to synthesize your findings
- Know the limitations of each sign