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Table 1 The diagnostic findings applied to assess traumatic chest injuries in physical exam and ultrasonography

From: Value of point-of-care ultrasonography compared with computed tomography scan in detecting potential life-threatening conditions in blunt chest trauma patients

Assessment Definition Simple pneumothorax Tension pneumothorax Hemothorax Massive hemothorax Pulmonary contusion
Findings of physical examination
 Inspection Chest expansion Nl-↓ Nl
Trachea Nl Deviated Nl Deviated Nl
Jugular vein pressure Nl Nl Nl
 Percussion The sound of striking 2 fingers on intercostal spaces Nl-hyperresonance Hyperresonance Nl-dull Dull Nl
 Auscultation To hear both sides comparatively and note sounds’ quality Nl-dull Nl-↓ Nl-crackles
Findings of ultrasonography
 Pleural sliding The shimmering movement of parietal pleura during inspiration Lost in injured zone Lost Nl May be Nl Maybe falsely ↓
 Seashore sign Normal lung M-mode of sandy appearance above and parallel lines below Lost in injured zone Lost Nl May be Nl May be Nl
 Barcode/stratosphere sign Abnormal M-mode showing multiple parallel lines + in injured zone + May be falsely +
 Lung point The interface of normal lung and pneumothorax area in B-M mode May be + Often -
 Sinusoid sign The sinusoidal movement of the collapsed lung in the pleural fluid + +
 V-line Echogenic vertebral line with posterior shadow due to the transmission of ultrasound waves through the pleural fluid May be + +
 B-lines/comet tails Vertical echogenic artifact lines from the pleura to the screen edge, if multiple, resulting from alveolo-interstitial syndrome (rocket sign) Lost Lost Nl May be Nl
 Peripheral parenchymal lesions Lung hepatization with subpleural hypoechoic foci and pleural line gap +