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INTRODUCTION
Air is the enemy of ultrasound (US) because it reflects the beam, preventing penetration of US into tissues. Due of this it was previously assumed that US could not be used to assess the lungs. However, we now know that the air-tissue interface creates artefacts which can be interpreted to determine the integrity of the lung parenchyma. There are actually many applications of ultrasound in evaluating lung pathology.
Lung ultrasound involves interpretation of artefacts at the air-tissue interface
Lung ultrasound was first described by Wernecke in 1987 as a tool to diagnose pneumothorax at the bedside (1). Since then clinicians have expanded the utility of US to diagnose a variety of lung pathologies. Daniel Lichtenstein and Giovanni Volpicelli have done the bulk of this early research and are generally considered to be the pioneers of lung ultrasound.
Research shows that in experienced hands the diagnostic accuracy of lung ultrasound approaches that of CT (2). A recent meta-analysis shows that lung US is far superior to the supine CXR for the detection of traumatic pneumothorax (3,4,5).
Lung US is also superior to CXR for several other commonly presenting pulmonary pathologies such as pneumonia, pleural effusion, pulmonary oedema and pulmonary contusion (6-11). US has also been shown to improve the success and reduce the morbidity associated with pleurocentesis (9).
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