Pleural Effusion: Ultrasound Accuracy and Related Symptoms

Q: Pleural Effusion: Ultrasound Accuracy and Related Symptoms

Hello： It is possible for a small amount of pleural effusion to be present only in the anterior part and not in the posterior part, although this situation is relatively rare. <br>It is also possible for the pleural effusion to resolve on its own (for example, if cardiac function

Pleural effusion

During a previous echocardiogram (performed from the anterior chest), the doctor mentioned that I have pleural effusion in the left thoracic cavity and advised me to see a pulmonologist.
After consulting the pulmonologist, the doctor first arranged for an X-ray, which did not show any issues, stating that if there was any fluid, it would be minimal.
A subsequent chest ultrasound (performed from the posterior) was conducted, and the doctor reported no problems.
My questions are: 1.
Are the results from the chest ultrasound performed from the back and the front both reliable? Or should the chest ultrasound be performed from the anterior, similar to the echocardiogram, to obtain results comparable to those of the echocardiogram? 2.
When I sleep on my left side for an extended period, I experience slight pain in the lower left rib area.
Could this be related to the pleural effusion mentioned during the echocardiogram? Which specialist should I consult for this issue?

bin, 40~49 year old female. Ask Date: 2019/05/24

Dr. Yang Wenda reply Pulmonology

Hello: It is possible for a small amount of pleural effusion to be present only in the anterior part and not in the posterior part, although this situation is relatively rare.
It is also possible for the pleural effusion to resolve on its own (for example, if cardiac function improves or after the administration of diuretics).
In the future, if necessary, follow-up can be done using chest X-rays.

Reply Date: 2019/05/24

More Info

Understanding pleural effusion and its diagnostic accuracy through ultrasound is crucial, especially when there are conflicting results from different imaging modalities. In your case, you have undergone both chest X-ray and ultrasound examinations, and there are some important points to consider regarding the reliability of these tests and the symptoms you are experiencing.

1. Ultrasound Accuracy and Imaging Approach:
Ultrasound is a highly effective tool for detecting pleural effusion due to its ability to visualize fluid collections in real-time. The accuracy of ultrasound can be influenced by the approach taken during the examination. While both anterior (front) and posterior (back) approaches can provide valuable information, they may yield different results based on the positioning of the patient and the location of the fluid.
In general, ultrasound from the back can be effective for assessing pleural effusion, especially in the lower lung fields where fluid tends to accumulate. However, the anterior approach is often preferred for certain conditions, as it allows for a more comprehensive view of the pleural space and the lung's anterior structures. The key is that both methods can be reliable, but the choice of approach may depend on the clinical context and the specific area of concern.

If the ultrasound from the back did not show any significant pleural effusion, it is likely that the previous findings from the heart ultrasound may not be directly related to a significant pleural effusion. However, if there is still a clinical suspicion of pleural effusion, further imaging or follow-up may be warranted.

2. Symptoms and Their Relation to Pleural Effusion:
The mild pain you experience in your left lower ribcage when lying on your left side could be attributed to several factors. While it is possible that this discomfort is related to pleural effusion, it could also be due to musculoskeletal issues, such as muscle strain or rib irritation, especially if the pain is positional and not constant.
If the pain persists or worsens, it would be advisable to consult a healthcare provider who specializes in thoracic medicine or pulmonology. They can perform a thorough evaluation, which may include a physical examination and possibly additional imaging studies, to determine the underlying cause of your symptoms.
Additionally, if there is any concern regarding the heart or if the pain is associated with other symptoms (such as shortness of breath, cough, or fever), it may be prudent to follow up with a cardiologist or a primary care physician who can coordinate care and ensure that all potential causes are explored.

In summary, both anterior and posterior ultrasound approaches can be reliable for assessing pleural effusion, but the choice of method may depend on the clinical scenario. Your symptoms may not necessarily indicate pleural effusion, and further evaluation by a specialist is recommended to clarify the cause of your discomfort. Always communicate openly with your healthcare providers about your symptoms and any concerns you may have regarding your health.

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