DIAGNOSTIC ACCURACY OF CHEST X-RAY IN THE DETECTION OF PNEUMOTHORAX IN BLUNT CHEST TRAUMA PATIENTS WITH CT AS THE GOLD STANDARD

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Danquale Vance Kynshikhar ◽  
Chaman Lal Kaushal ◽  
Ashwani Tomar ◽  
Neeti Aggarwal
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Trauma Patients ◽  
Care Level ◽  
X Ray ◽  
Primary Health ◽  
Chest X Ray

Background: To study the diagnostic accuracy of chest X-ray in the detection of pneumothorax in blunt chest trauma patients with CT as the Gold Standard Methods: The present study was conducted from 31th July 2018 to 30th July 2019. A total of 36 patients were enrolled in the study. Results: On Chest X-Ray Supine AP view, pneumothorax was detected in 11 of 24 patients. The sensitivity of Chest X-Ray Supine AP view was 45.83%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 48% and accuracy was 63.89% for the diagnosis of pneumothorax. Conclusion: A Chest radiograph is the most preferred and relevant primary investigation in the diagnosis of pneumothorax even with the various advanced techniques that are available. X-ray being relatively cheaper and is easily available even at the peripheral centers at the primary health care level. Keywords: X-ray, CT, Pneumothorax

scholarly journals DIAGNOSTIC ACCURACY OF ULTRASOUND IN THE DETECTION OF PNEUMOTHORAX IN CHEST TRAUMA PATIENTS WITH CT AS THE GOLD STANDARD

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Danquale Vance Kynshikhar ◽  
Chaman Lal Kaushal ◽  
Ashwani Tomar ◽  
Neeti Aggarwal
Keyword(s):  
Emergency Department ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Chest Trauma ◽  
Accurate Diagnosis ◽  
Trauma Patients ◽  
Chest Ultrasound

Background: To study the diagnostic accuracy of ultrasound in the detection of pneumothorax in chest trauma patients with CT as the Gold Standard Methods: The present study was conducted from 31th July 2018 to 30th July 2019. A total of 36 patients were enrolled in the study. Results: By chest ultrasound, pneumothorax was detected in 15 of 24 patients. The sensitivity of chest ultrasound for the diagnosis of pneumothorax was 62.5%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 54.14% and accuracy was 75%. Conclusion: Chest ultrasound can play an important role in the emergency department aiding a physician for bedside rapid and accurate diagnosis of pneumothorax without interruption in the resuscitation process and without transferring the patient to the radiology section. Keywords: Ultrasound, CT, Pneumothorax

Ultrasound Detection of Pneumothorax Compared with Chest X-Ray and Computed Tomography Scan

2011 ◽  
Vol 77 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Khanjan Nagarsheth ◽  
Stanley Kurek
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Chest Ct ◽  
Trauma Patients ◽  
X Rays ◽  
Thoracic Ultrasound ◽  
X Ray ◽  
Chest X Ray ◽  
Chest Ct Scan

Pneumothorax after trauma can be a life threatening injury and its care requires expeditious and accurate diagnosis and possible intervention. We performed a prospective, single blinded study with convenience sampling at a Level I trauma center comparing thoracic ultrasound with chest X-ray and CT scan in the detection of traumatic pneumothorax. Trauma patients that received a thoracic ultrasound, chest X-ray, and chest CT scan were included in the study. The chest X-rays were read by a radiologist who was blinded to the thoracic ultrasound results. Then both were compared with CT scan results. One hundred and twenty-five patients had a thoracic ultrasound performed in the 24-month period. Forty-six patients were excluded from the study due to lack of either a chest X-ray or chest CT scan. Of the remaining 79 patients there were 22 positive pneumothorax found by CT and of those 18 (82%) were found on ultrasound and 7 (32%) were found on chest X-ray. The sensitivity of thoracic ultrasound was found to be 81.8 per cent and the specificity was found to be 100 per cent. The sensitivity of chest X-ray was found to be 31.8 per cent and again the specificity was found to be 100 per cent. The negative predictive value of thoracic ultrasound for pneumothorax was 0.934 and the negative predictive value for chest X-ray for pneumothorax was found to be 0.792. We advocate the use of chest ultrasound for detection of pneumothorax in trauma patients.

scholarly journals Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Mansella ◽  
Roland Bingisser ◽  
Christian H. Nickel
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Common Mechanism ◽  
Cervical Trauma ◽  
X Ray ◽  
Retrosternal Pain ◽  
Chest X Ray ◽  
Bedside Diagnosis

Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.

scholarly journals 732. Sensitivity and Specificity of Point of Care Lung Ultrasound vs. Chest X-Ray for the Diagnosis of Pediatric Pneumonia in Limited resource settings: The Zambia Experience

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S464-S464
Author(s):  
Ingrid Y Camelo ◽  
Rachel Pieciak ◽  
Ilse castro-aragon ◽  
Bindu Setty ◽  
Lauren Etter ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Point Of Care ◽  
Severe Pneumonia ◽  
Limited Resource ◽  
Ultrasound Images ◽  
X Ray ◽  
Pediatric Pneumonia ◽  
Chest X Ray

Abstract Background Pediatric pneumonia is the leading cause of child mortality in low-income countries. Pneumonia diagnosis is a challenge. Chest x-ray (CXR) is considered the gold standard, but it exposes children to ionizing radiation, and access to CXR is limited to hospital settings. Lung Point of Care Ultrasound (POCUS) is a portable and non-radiating alternative to CXR. Methods We enrolled 200 children aged 1-59 months from the University Teaching Hospital (UTH) Emergency Department (ED) in Lusaka, Zambia who met the WHO (World Health Organization) case definition for severe pneumonia. From each child, we collected demographic and clinical data, a CXR, and a set of ultrasound images using a Butterfly ultrasound probe. Images were independently interpreted by two radiologists blinded to the results of the other imaging modality. Using CXR as the gold standard, we determined the sensitivity and specificity, positive and negative predictive values, and likelihood ratios for pneumonia using lung POCUS. Results This preliminary analysis included 50 children seen between May-October 2020. Median age (9 months) (Range 4-15). 58% were male, (29/50). Median temperature was 37.3⁰C (range 36.5-38.0); median respiratory and pulse rates were 41 breaths/min (range 31-50) and 139 beats/min (range 124-160) respectively; median SpO2 on RA was 91% (range 89-95). 50% of cases had difficulty breathing (82%, 41/50); chest retractions (70%, 35/50) and grunting (62%, 31/50). Ultrasound images for 49/50 (98%) cases and CXRs for 50/50 (100%) of cases we analyzed. Sensitivity of lung POCUS in the detection of CAP was 61% (95% Cl: 0.52-0.84). The specificity was 77% (95% Cl: 0.56-0.91). Positive predictive value (PPV) 70% (95% CI: 0.62-0.94) and negative predictive value (NPV) 69% (95% CI: 0.56-0.79). Conclusion Preliminary findings of this study demonstrated the lower diagnostic accuracy of lung POCUS versus CXR in the detection of pneumonia in children 1- 59 months. The high specificity of the test will aid in ruling out severe pneumonia in children. Due to its availability, ease of interpretation, and absence of radiation exposure, lung POCUS should still be considered as an important initial imaging tool for the diagnosis of CAP in children in limited-resource settings. Disclosures All Authors: No reported disclosures

scholarly journals Comparison of Lung Ultrasound to X-ray for Diagnosis of Pulmonary Complications after Cardiac Surgery in Children

2020 ◽  
Vol 18 (1) ◽  
pp. 47-51
Author(s):  
Smriti Mahaju Bajracharya ◽  
Pragati Shrestha ◽  
Apurb Sharma
Keyword(s):  
Cardiac Surgery ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Lung Ultrasound ◽  
Pulmonary Complications ◽  
Lung Ultrasonography ◽  
X Ray ◽  
Chest X Ray

Background: The purpose of this study was to compare diagnostic performance of lung ultrasound in comparison to chest X-ray to detect pulmonary complication after cardiac surgery in children.Methods: A prospective observational study was conducted in tertiary center of Nepal. 141 consecutive paediatric patients aged less than 14 years scheduled for cardiac surgery were enrolled during the 6 months period. Ultrasound was done on the first post-operative day of cardiac surgery and compared to chest X-ray done on the same day to detect pleural effusion, consolidation, atelectasis and pneumothorax.Results: Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy were calculated using standard formulas. lung ultrasonography had overall sensitivity of 60 %, specificity of 72.4%, positive predictive value of 31.9% and negative predictive value of 89.3% and diagnostic accuracy of 70.2% for diagnosing consolidation. Similarly, lung ultrasonography had overall sensitivity of 90%, specificity of 82.6%, positive predictive value of 46.1% and negative predictive value of 98% and diagnostic accuracy of 83.6 % for diagnosing pleural effusion. For atelectasis, ultrasonography had sensitivity of 50%, specificity of 76.9%, positive predictive value of 30.7% and negative predictive value of 88.2% and diagnostic accuracy of 72.3%. No pneumothoraxes were detected during our study period. Conclusions: Lung ultrasound is an alternative non-invasive technique which is able to diagnose pulmonary complications after cardiac surgery with acceptable diagnostic accuracy with no proven complications but with decreasing exposure to ionizing radiation and possibly cost.Keywords: Cardiac surgery; children; lung ultrasound; pulmonary complications

scholarly journals Solitary Pulmonary Hematoma Radiographically Indistinguishable from Mediastinal Tumor

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Teruya Komatsu ◽  
Naoki Date ◽  
Takuji Fujinaga ◽  
Akira Hara ◽  
Tatsuo Kato
Keyword(s):  
Blunt Chest Trauma ◽  
Mediastinal Tumor ◽  
Chest Trauma ◽  
Callus Formation ◽  
Wedge Resection ◽  
Lower Lobe ◽  
X Ray ◽  
Pulmonary Tumor ◽  
Chest X Ray ◽  
Posterior Mediastinal

Solitary pulmonary hematoma is a rare consequence of blunt chest trauma. Moreover, there has been no reported case of solitary pulmonary hematoma radiographically diagnosed as a posterior mediastinal tumor. We present the case of a 63-year-old man who was referred for an oval-shaped opacity at the left paraspinal area on a chest X-ray. Chest computed tomography showed a well-circumscribed posterior mediastinal tumor on the left paraspinal lesion with extrapleural sign and callus formation on the left ribs posteriorly (7th to 11th ribs). The tumor was thoracoscopically confirmed to be a subpleural pulmonary tumor of the left lower lobe, and wedge resection was performed. Histological examination confirmed the diagnosis of pulmonary hematoma. On reviewing the callus formation of the ribs, which was suggestive of rib fractures, the pulmonary hematoma was determined to be traumatic in origin. The postoperative course was uneventful. We reviewed a rare case of pathologically proven traumatic solitary pulmonary hematoma. The rarity of this case is enhanced because the hematoma initially appeared to be a posterior mediastinal tumor.

scholarly journals Does Radar Technology Support the Diagnosis of Pneumothorax? PneumoScan—A Diagnostic Point-of-Care Tool

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
T. Lindner ◽  
M. Conze ◽  
C. E. Albers ◽  
B. A. Leidel ◽  
P. Levy ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Predictive Value ◽  
Chest Trauma ◽  
Point Of Care ◽  
Diagnostic Value ◽  
Technology Support ◽  
Trauma Room ◽  
X Ray ◽  
Life Threatening ◽  
Chest X Ray

Background. A nonrecognized pneumothorax (PTX) may become a life-threatening tension PTX. A reliable point-of-care diagnostic tool could help in reduce this risk. For this purpose, we investigated the feasibility of the use of the PneumoScan, an innovative device based on micropower impulse radar (MIR).Patients and Methods. addition to a standard diagnostic protocol including clinical examination, chest X-ray (CXR), and computed tomography (CT), 24 consecutive patients with chest trauma underwent PneumoScan testing in the shock trauma room to exclude a PTX.Results. The application of the PneumoScan was simple, quick, and reliable without functional disorder. Clinical examination and CXR each revealed one and PneumoScan three out of altogether four PTXs (sensitivity 75%, specificity 100%, positive predictive value 100%, and negative predictive value 95%). The undetected PTX did not require intervention.Conclusion. The PneumoScan as a point-of-care device offers additional diagnostic value in patient management following chest trauma. Further studies with more patients have to be performed to evaluate the diagnostic accuracy of the device.

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