The Efficacy of Bedside Chest Ultrasound in the Detection of Traumatic Pneumothorax

Chest X-rays have long been used to diagnose pneumothorax. In trauma patients, chest ultrasonography combined with chest CT may be a safer, faster, and more accurate approach. This could lead to better and quicker management of traumatic pneumothorax, as well as enhanced patient safety and clinical results.

The purpose of this study was to assess the efficacy and utility of bedside US chest in identifying traumatic pneumothorax and also its capacity to estimate the extent of the lesion in comparison to the gold standard modality chest computed tomography.

This was an observational cross-sectional study of 160 patients with traumatic pneumothorax. This sample was collected from all chest trauma patients admitted to Al-Kindy Teaching Hospital in Baghdad-Iraq between November 2021 and September 2022. Such patients were to have a bedside chest US and chest CT scan performed by a skilled radiologist to detect lung point signs and lung sliding, which would be used to determine the patient's pneumothorax status.

According to the study's findings, about 77.5% of the patients evaluated were men. Furthermore, 40.6% of patients experienced blunt trauma. Chest ultrasound revealed positive pneumothorax in 50 cases (31.2%), while positive pneumothorax was confirmed by computed tomography in 53 cases (33.1%) with no significance in the detection of pneumothorax between the two imaging modalities p-value(0.719). Comparably, there was no significant difference in estimating the size of a pneumothorax between the two modalities (p-value = 0.547). Chest ultrasound diagnostic accuracy showed a sensitivity of approximately 92.45%, specificity of 99.07%, and diagnostic accuracy of 96.88%.

Our findings indicated that chest ultrasound might be a valuable rapid diagnostic tool for traumatic pneumothorax in the emergency department in addition to diagnosis. It eliminates the need to transport patients for a CT chest scan.