Chest ultrasound

Chest diagnostic imaging is essential when dealing with a critically ill patient. At present, direct visualization of the lung parenchyma is performed with a chest x-ray (CXR) and computed tomography (CT), with the patient in the supine position. In the ICU, chest x-rays is only performed on patients in the supine position. The x-ray beam is positioned directly onto the chest at a film distance of less than sixfeet. In fact, when the x-ray beam does not falltangentially on the diaphragm dome and the mediastinal structures, a correct diagnosis of the “silhouette sign” may not be achieved. Hence itmay result in diagnostic errors regarding pleural effusions, parenchymal consolidation, and alveolar interstitial syndrome.Chest sonography is made feasible by the interpretation of ultrasound artifacts that arise from the chest wall and pleural surface. A brief review of the relevant normal anatomy will provide the framework to facilitate an understanding of the various patterns one may encounter when performing lung sonography