Diagnosing pleural effusion: A prospective comparison of physical examination with bedside thoracic ultrasonography

Patterson, Leigh; Costantino, Thomas; Satz, Wayne A.

doi:10.1016/j.annemergmed.2004.07.364

Cited by 4 publications

(9 citation statements)

References 0 publications

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“…Few studies directly compared PE with bedside US for pleural effusion. Five prior studies reported that US was superior [10][11][12][13][14]. However, in at least four of these studies, only auscultation was performed [11][12][13][14], and auscultation is known to be less accurate than other PE maneuvers [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, only 60% of medical residents accurately detected bronchial breath sounds [8], such as those that might occur above the level of a pleural effusion [9], with no appreciable increase in auscultation accuracy between 1st year and 3rd year residents [8]. While studies suggest that US outperforms PE for detecting pleural effusion [10][11][12][13][14], many studies used only auscultation as the comparator, rather than a comprehensive PE. Thus, the superior performance of US in these studies may be exaggerated.…”

Section: Introductionmentioning

confidence: 99%

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Comparing accuracy of bedside ultrasound examination with physical examination for detection of pleural effusion

et al. 2021

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Background In detecting pleural effusion, bedside ultrasound (US) has been shown to be more accurate than auscultation. However, US has not been previously compared to the comprehensive physical examination. This study seeks to compare the accuracy of physical examination with bedside US in detecting pleural effusion. Methods This study included a convenience sample of 34 medical inpatients from Calgary, Canada and Spokane, USA, with chest imaging performed within 24 h of recruitment. Imaging results served as the reference standard for pleural effusion. All patients underwent a comprehensive lung physical examination and a bedside US examination by two researchers blinded to the imaging results. Results Physical examination was less accurate than US (sensitivity of 44.0% [95% confidence interval (CI) 30.0–58.8%], specificity 88.9% (95% CI 65.3–98.6%), positive likelihood (LR) 3.96 (95% CI 1.03–15.18), negative LR 0.63 (95% CI 0.47–0.85) for physical examination; sensitivity 98% (95% CI 89.4–100%), specificity 94.4% (95% CI 72.7–99.9%), positive LR 17.6 (95% CI 2.6–118.6), negative LR 0.02 (95% CI 0.00–0.15) for US). The percentage of examinations rated with a confidence level of 4 or higher (out of 5) was higher for US (85% of the seated US examination and 94% of the supine US examination, compared to 35% of the PE, P < 0.001), and took less time to perform (P < 0.0001). Conclusions US examination for pleural effusion was more accurate than the physical examination, conferred higher confidence, and required less time to complete.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing accuracy of bedside ultrasound examination with physical examination for detection of pleural effusion

et al. 2021

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“…lists the most common physical signs of pleural effusion [10][11][12][13][14][15] ; TABLE 2 lists some less common (anecdotal) signs. 11,[14][15][16] The sensitivities and specificities of the different signs in detecting pleural effusion have not been extensively studied. The limited data suggest that clinical acumen is less accurate than ultrasonography of the chest, but certain reports found it about as accurate as standard chest radiography.…”

Section: ■ Physical Examination: Long Tradition Few Datamentioning

confidence: 99%

“…Patterson et al 11 prospectively compared physical examination (including auscultation, percussion, and tactile fremitus) with bedside ultrasonography and found that physical examination had a lower sensitivity (53% vs 80%, respectively) but a similar specificity (71%).…”

Section: ■ Physical Examination: Long Tradition Few Datamentioning

confidence: 99%

“…Skodaic resonance 14 Area of hyperresonance above a pleural effusion Succussion splash 16 Splashing sound produced by violently shaking patients with hydropneumothorax Grocco triangle 15 Right-angle triangle of dullness found over the posterior region of the chest opposite a large pleural effusion Garland triangle 11 Small area of resonance next to the spine found in patients with large unilateral pleural effusions shows some of the common physical findings, depending on the amount of pleural fluid present.…”

Section: Sign Descriptionmentioning

confidence: 99%

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Accuracy of the physical examination in evaluating pleural effusion

Diaz-Guzman

Budev

2008

Cleveland Clinic Journal of Medicine

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A careful physical examination is a valuable and noninvasive means of assessing pleural effusion and should be routinely performed in every patient in whom this condition is suspected. Although physical examination is less accurate than ultrasonography or computed tomography in detecting a pleural effusion, the sensitivity and specificity of the different physical signs of pleural effusion may be comparable to those of conventional chest radiography.

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Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination

Steinmetz

Oleskevich

Dyachenko

et al. 2018

J of Ultrasound Medicine

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Diagnosing pleural effusion: A prospective comparison of physical examination with bedside thoracic ultrasonography

Cited by 4 publications

References 0 publications

Comparing accuracy of bedside ultrasound examination with physical examination for detection of pleural effusion

Comparing accuracy of bedside ultrasound examination with physical examination for detection of pleural effusion

Accuracy of the physical examination in evaluating pleural effusion

Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination

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