When is a Lung Point not a Lung Point?

(This post was first published on blog.5minsono.com on December 12, 2015)

I’ve been struggling with something recently.  When I first learned about the lung point, I was ecstatic! A finding that is 100% specific for a pneumothorax? Fantastic!

Unfortunately, I think it’s too good to be true.  The two studies used to describe the specificity of a lung point were both published by the same ICU sonographer.  One was a “prospective” study where they found patients who had a known pneumothorax, then went back and ultrasounded them looking for a lung point.  The other was a retrospective review of patients with occult pneumothorax seen on CT and US that were missed on chest x-ray.

I’m not at all saying the lung point is useless. In reality, the lung point probably has an extremely high specificity, I’m just not convinced that the true specificity is as high as has been reported.  Watch the following video to see what I mean:


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