Peter Doelken, MD

ABSTRACT: The increasing availability of bedside ultrasonographyallows for more timely diagnosis and treatment of pleuraleffusion while limiting the patient's exposure to radiation. Thedynamic signs characteristic of pleural effusions includerespirophasic changes in the shape of the fluid collection, floatingmovements of atelectatic lung, and the plankton sign. Ultrasonographyalso is an efficient means of excluding pneumothoraxwhen rapid diagnosis is needed or after interventionssuch as central line placement, lung or pleural biopsy, or thoracentesis.The diagnosis of a pneumothorax relies on the absenceof dynamic signs such as "lung sliding." Static signs, suchas the comet tail artifact, or consolidated lung parenchyma orlung tissue that contains a solid mass, also can be useful in excludingpneumothorax. Ultrasonography can be used to guidefine-needle aspiration and core biopsies of pleural nodules,pleural thickening, and subpleural lung masses. (J Respir Dis.2008;29(5):200-207)