Bedside Sonographic Diagnosis of Pneumothorax in Pediatric Patients: A Preliminary Report

Background: Development of thoracic ultrasound made it a useful tool for diagnosing respiratory disorders. But it has been rarely described in literatures about the accuracy of sonographic signs specific to pneumothorax. We studied the sonographic findings of pneumothorax in children and examined the patients with chest pain and/or dyspnea in our pediatric emergency department to determine the performance of thoracic ultrasound in children with pneumothorax. Methods: This is a prospective blinded observational study between 2010 and 2011. Patients less than 18 years of age admitted with chest pain and/or dyspnea to our pediatric emergency department were analyzed. Patients were categorized into two groups: a pneumothorax group and a pneumothorax free (control group). Patients with any lung disorder were excluded as control group. Each patient underwent thoracic ultrasound and chest radiography on the anterior and lateral chest. Results: Eight patients with pneumothorax and 30 with pneumothorax free were enrolled. The age ranged from 15 to 18 years old. The sensitivity, specificity, negative predictive values of loss of “lung sliding” sign and “lung point” sign in the diagnosis of pneumothorax were all 100%. The sensitivity of “loss of comet-tail sign” was 98%, specificity 40%, negative predictive value 99%. Conclusion: Thoracic ultrasound is a useful diagnostic tool for children with pneumothorax. An absence of “lung sliding” plus the presence of a “lung point” sign at the anterior chest wall is indicative of pneumothorax. (J Pediatr Resp Dis 2013;9:81-86)