Razi Journal of Medical Sciences

Background: Pneumothorax may be associated with penetrating or blunt chest traumas' that need early diagnosis and treatment. Today the diagnosis modalities are CXR and CT-Scan that are not suitable for unstable patients. Chest sonography can be a fast diagnostic method at patient bedside. The purpose of this study was to evaluate the accuracy of bedside ultrasonography in diagnosis of pneumothorax.

Methods: In this prospective study, 60 cases suspicious of pneumothorax were included in study. Bedside ultrasonography was performed for all the cases. Sonography site was between parasternal and midclavicular lines in 2^nd to 4^th intercostals spaces of both thoracic sites and performed between 5-10 respiratory cycles. Gold standard results for definite diagnosis were: positive results of chest X ray, chest CT scan and/or air leak after needle or tube thoracostomy. In suspicious results, CT scan was done. Data were analyzed accordingly with statistic tests of “Chi-Square” and “Fisher’s Exact Test”. SPSS V.12 was also used.

Results: Trauma mechanism in 5 cases (8.3%) was stab wound, and in 53 cases(88.3%) multiple trauma there was 1 case of tuberculosis and 1 case of blunt chest trauma as well. Eleven out of the 12 pneumothorax cases (proven by chest Xray or CT scan) were diagnosed by bedside sonography. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of bedside ultrasonography for diagnosis of pneumothorax were 91.6%, 100%, 100%, 97.9% and 98.6%, respectively.

Conclusion: With respect to the results of this study and previous studies, bedside ultrasonography is a good method for diagnosis of pneumothorax.