THE DIAGNOSTIC VALUE OF THE X-RAY IN CERTAIN INTRATHORACIC DISEASES: PLEURAL EFFUSIONS, BRONCHIECTASIS, AND ATELECTASIS

ABSTRACT Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard. Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology OPD-Gulab Devi Teaching Hospital, Lahore from November 2016 to July 2018. Adult patients with clinical features suggesting pleural effusions were included while those where no suspicion of pleural effusion, patients < 14 years and pregnant ladies were excluded. Patients were subjected to chest x-ray PA and Lateral views and chest ultrasonography was done by a senior qualified radiologist in OPD. Ultrasound-guided pleural aspiration was done in OPD & fluid was sent for analysis. At least 10ml aspirated fluid was considered as diagnostic for pleural effusion. Patient files containing history, physical examination, x-ray reports, ultrasound reports, pleural aspiration notes and informed consent were retrieved, reviewed and findings were recorded in the preformed proforma. Results were tabulated and conclusion was drawn by statistical analysis. Results: Out of 4597 cases, 4498 pleural effusion were manifested on CXR and only 2547(56.62%) pleural effusions were proved by ultrasound while 2050 (45.57%) cases were reported as no Pleural effusion. Chest sonography demonstrated sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. Conclusions: Trans-thoracic ultrasonography revealed an excellent efficacy that is why it can be considered as non-invasive gold standard for the detection of pleural effusion.

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Diagnostic Value of Total and Differential Leukocyte Counts in Pleural Effusions

Acta Medica Scandinavica ◽

10.1111/j.0954-6820.1981.tb09788.x ◽

2009 ◽

Vol 210 (1-6) ◽

pp. 129-135 ◽

Cited By ~ 20

Author(s):

Tom Pettersson ◽

Henrik Riska

Keyword(s):

Diagnostic Value ◽

Pleural Effusions ◽

Leukocyte Counts

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Diagnostic Value and Prognostic Significance of Pleural C-Reactive Protein in Lung Cancer Patients with Malignant Pleural Effusions

Yonsei Medical Journal ◽

10.3349/ymj.2013.54.2.396 ◽

2013 ◽

Vol 54 (2) ◽

pp. 396 ◽

Cited By ~ 2

Author(s):

Do-Sim Park ◽

Dong Kim ◽

Ki-Eun Hwang ◽

Yu-Ri Hwang ◽

Chul Park ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Prognostic Significance ◽

Diagnostic Value ◽

Pleural Effusions ◽

C Reactive Protein ◽

Lung Cancer Patients ◽

Malignant Pleural Effusions ◽

Reactive Protein

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Diagnostic value of medical thoracoscopy for undiagnosed pleural effusions

Experimental and Therapeutic Medicine ◽

10.3892/etm.2018.6742 ◽

2018 ◽

Author(s):

Rui‑Lin Chen ◽

Yong‑Qing Zhang ◽

Jun Wang ◽

Hua Wu ◽

Shu‑Mei Yang

Keyword(s):

Diagnostic Value ◽

Pleural Effusions ◽

Medical Thoracoscopy

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Interest of Ultrasound in the Exploration of Rotator Cuff Lesions - Confrontation of Clinical Examination and Ultrasound Finding

International Journal of Medicine and Surgery ◽

10.15342/ijms.v5ir.219 ◽

2018 ◽

Vol 5 ◽

Author(s):

Nessrine Akasbi ◽

Asmae El Aissaoui ◽

Ikrame Yazghich ◽

Samira El Fakir ◽

Taoufik Harzy

Keyword(s):

Rotator Cuff ◽

Physical Examination ◽

Clinical Examination ◽

High Sensitivity ◽

Diagnostic Value ◽

Ultrasound Finding ◽

X Ray ◽

Rotator Cuff Lesion ◽

Rotator Cuff Lesions ◽

A Prospective Study

Introduction: The aim of our study was to evaluate the interest of ultrasound in the exploration of painful shoulders evoking rotator cuff lesions and to determine the diagnostic value of the different tendon tests through a confrontation physical examination versus shoulder ultrasound. Materials and methods: A prospective study was conducted including patients consulting for shoulder pain that suggests a rotator cuff lesion. All patients underwent a clinical examination, an x ray and shoulder ultrasound.Results: The confrontation physical examination versus shoulder ultrasound showed that Jobe's test is very sensitive (100%) but less specific (27%), the Patte test, has a high sensitivity (100%) but an average specificity (51%), the Palm-Up test was fairly sensitive (91%) but not very specific (43%) and the Gerber test was more specific (95.7%) and less sensitive (38%). The comparison between x ray and ultrasound showed that ultrasound of shoulder is more efficient in the detection of calcifications and erosions of humeral head.Conclusion: Ultrasound of shoulder is more performant than physical examination and x ray in exploring the rotator cuff lesions.

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A Study on Diagnostic Value of Lysozyme Activity in Various pleural effusions

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.1989.36.2.120 ◽

1989 ◽

Vol 36 (2) ◽

pp. 120-126

Author(s):

Hyung Jung Kim ◽

Seung Min Kwak ◽

Chul Min Ahn ◽

Sung Kyu Kim ◽

Won Young Lee

Keyword(s):

Diagnostic Value ◽

Lysozyme Activity ◽

Pleural Effusions

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The diagnostic value of chest X-ray in coronavirus disease 2019: A comparative study of X-ray and CT

Science Progress ◽

10.1177/00368504211016204 ◽

2021 ◽

Vol 104 (3) ◽

pp. 003685042110162

Author(s):

Fengxia Zeng ◽

Yong Cai ◽

Yi Guo ◽

Weiguo Chen ◽

Min Lin ◽

...

Keyword(s):

Clinical Symptoms ◽

Diagnostic Value ◽

Rapid Identification ◽

Chest Ct ◽

Ct Scans ◽

Ground Glass ◽

X Ray ◽

Chest X Ray ◽

Laboratory Examinations ◽

Sensitivity Specificity

As the coronavirus disease 2019 (COVID-19) epidemic spreads around the world, the demand for imaging examinations increases accordingly. The value of conventional chest radiography (CCR) remains unclear. In this study, we aimed to investigate the diagnostic value of CCR in the detection of COVID-19 through a comparative analysis of CCR and CT. This study included 49 patients with 52 CT images and chest radiographs of pathogen-confirmed COVID-19 cases and COVID-19-suspected cases that were found to be negative (non-COVID-19). The performance of CCR in detecting COVID-19 was compared to CT imaging. The major signatures that allowed for differentiation between COVID-19 and non-COVID-19 cases were also evaluated. Approximately 75% (39/52) of images had positive findings on the chest x-ray examinations, while 80.7% (42/52) had positive chest CT scans. The COVID-19 group accounted for 88.4% (23/26) of positive chest X-ray examinations and 96.1% (25/26) of positive chest CT scans. The sensitivity, specificity, and accuracy of CCR for abnormal shadows were 88%, 80%, and 87%, respectively, for all patients. For the COVID-19 group, the accuracy of CCR was 92%. The primary signature on CCR was flocculent shadows in both groups. The shadows were primarily in the bi-pulmonary, which was significantly different from non-COVID-19 patients ( p = 0.008). The major CT finding of COVID-19 patients was ground-glass opacities in both lungs, while in non-COVID-19 patients, consolidations combined with ground-glass opacities were more common in one lung than both lungs ( p = 0.0001). CCR showed excellent performance in detecting abnormal shadows in patients with confirmed COVID-19. However, it has limited value in differentiating COVID-19 patients from non-COVID-19 patients. Through the typical epidemiological history, laboratory examinations, and clinical symptoms, combined with the distributive characteristics of shadows, CCR may be useful to identify patients with possible COVID-19. This will allow for the rapid identification and quarantine of patients.

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