The chest

Lung ultrasound is more accurate than clinical examination and chest X-ray for pleural disease (e.g. pneumothorax, pleural effusion) and pulmonary disease (e.g. consolidation, pulmonary oedema/fibrosis). Begin with a curved probe with the depth set at 15 cm and with the probe placed perpendicular to the ribs, with ‘filters’ (tissue harmonics and compounding) ideally turned off. M-mode may assist but normally is not required. Change to a linear probe for fine detail (pleural space and subpleural consolidation). Doppler is not normally recommended but has been used to differentiate pleural fluid from thickening and to differentiate the causes of consolidation.