If there ever was a post worth reading about pneumothorax, this excellent review by EM Lyceum was too good not to pass along to everyone. Now I don’t know about you, but I always get asked the questions about chest Xray versus Ultrasound, what to do when only the ultrasound shows the pneumothorax (because you know it’s better than Chest Xray! as discussed in a prior post), when to order that CT chest, and how should you treat it: nothing? pigtail? small chest tube? large chest tube? EM Lyceum does a great job in reviewing this using literature to back it up. There have been more studies that haven’t been mentioned with regard to ultrasound and pneumothorax diagnosis, and the sensitivity and specificity of chest xray is stated pretty high as prior studies tend to do (with more accurate and recent ones stated by EM Lyceum to be lower (in the real world that we work in). And, there was a great meta-analysis in Chest Journal speaking of which imaging modality was better, chest Xray or ultrasound. Go to the EM Lyceum site and read-on to grasp the answers to all the questions! Thank you EM Lyceum – this was awesome!

By BTS 2010 guidelines (Macduff, 2010).