IOTW: Lung Ultrasound

Posted on: May 16, 2019, by :

Lung ultrasound can be useful in elucidating the cause of acute dyspnea. This week’s images are of a 2 year old female with respiratory distress and fever.

In image 1 there is normally aerated lung viewed in the transverse plane as evidenced by the smooth white pleural line and A line artifacts.

In image 2 the white pleural line is interrupted by an irregularly shaped area concerning for consolidation

The sonographer, Dr. Lawson, appreciated this difference in the transverse plane and interrogated the area further by evaluating it in the longitudinal plane.

Within this view, the sonographer rotated the probe 90 degrees so that the ribs are out of view and the image is focused on the lung. In this image we are able to appreciate that the pleural line is interrupted by a shredded appearing border that almost appears as if a chunk has been taken from the lung, this is a consolidation. 

This area can be compared to the 4th image of normally aerated lung without a consolidation in the longitudinal plane.

“The information in these cases has been changed to protect patient identity and confidentiality. The images are only provided for educational purposes and members agree not to download them, share them, or otherwise use them for any other purpose.”

Carrie Ng

Pediatric Emergency Medicine Attending at Children's National Health System
Carrie was born in San Francisco, but grew up between Hong Kong and Los Angeles. Although she loves the sun, she was excited to move away from home to Philadelphia for medical school, where she explored a new city, learned to appreciate all four seasons, and met her Canadian husband. She then moved to New York City and completed her Pediatrics residency at NYU and PEM fellowship at Columbia. During this time, Carrie developed a passion for bedside ultrasound and decided to join the CNMC faculty while pursuing an Emergency Ultrasound fellowship. In her spare time, Carrie loves traveling, listening to podcasts, and playing board games.

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