aIndicative imaging performed | Role of the imaging of these structures | Role within physiotherapy and wider MDT patient management |
---|---|---|
∆Recognition of normal thoracic structures and adjacent organs as landmarks • Subcutaneous tissues, ribs, pleura and diaphragm • Heart, liver, spleen and kidneys • Aorta and vena cava | Awareness of spectrum of ‘normal’ presentations. Landmark identification serves as mechanism to enhance accuracy of imaging; integral aspect of protocol-based imaging | Recognition of ‘normal’ as part of sonographic and clinical differential diagnosis process. Standardised approach to imaging as quality assurance mechanism |
◊Identification of ultrasound appearances of normal aerated lung including • Pleural line and lung sliding (in 2D/B mode and M mode) • Normal aerated lung (including A-line and B-line artefacts) | Awareness of ‘normal’ presentations | Recognition of ‘normal’ as part of sonographic and clinical differential diagnosis process |
Recognition of pleural fluid: • Appearances of pleural fluid and pleural thickening • Estimation of pleural effusion volume • Demonstration of sinusoid sign on M mode • Distinguishing between pleural and abdominal fluid collection | Building upon ∆ and ◊, sonographic differential diagnosis, description and (where appropriate) estimation of pleural effusion | Feeds into clinical differential diagnosis process; also monitoring of severity and response to treatment/intervention |
Recognition of consolidation/atelectasis: • Ultrasound appearances of consolidated/atelectatic lung • Ultrasound appearances of air and fluid bronchograms | Building upon ∆ and ◊, sonographic differential diagnosis and description of consolidation/atelectasis and types of bronchograms | Feeds into clinical differential diagnosis process; also monitoring of severity and response to treatment/intervention |
Recognition of interstitial syndrome: • Recognition of B-lines • Differentiating between normal and pathological B-lines | Building upon ∆ and ◊, sonographic differential diagnosis and description of interstitial syndrome | Feeds into clinical differential diagnosis process; also monitoring of severity and response to treatment |
Use of ultrasound to exclude pneumothorax: • Recognition of signs of pneumothorax (B mode and M mode) • Absence of lung sliding, B-lines and lung pulse • Presence of lung point | Building upon ∆ and ◊, exclusion of pneumothorax | Feeds into clinical differential diagnosis process |