COMPARING DIAGNOSTIC ACCURACY OF LUNG ULTRASOUND AGAINST CHEST XRAY FOR DETECTION OF PNEUMOTHORAX USING HRCT AS GOLD STANDARD.

Thoracic trauma is one of the most common locations of injury with an overall mortality rate of up to 10% making its recognition a priority in chest trauma assessment . Imaging plays a key role in guiding interventions and management in patients with chest trauma. Conventional imaging in the form of chest radiographs, ultrasounds, and computed tomography (CT) are usually performed in the emergency settings with CT scan as the gold standard for this diagnosis. But high radiation dose in CT scan has made chest X-ray a popular initial diagnostic tool in these cases. Apart from various disadvantages of chest X ray, many studies suggest its poor sensitivity and specicity in identifying intrathoracic injuries culminating in lower diagnostic yield. Recently, chest ultrasonography has emerged as a portable, inexpensive, safe, and fast alternative for radiography in detection of traumatic intrathoracic injuries. So, the present study was undertaken to compare the diagnostic accuracy of this newly surfaced chest ultrasonography and the conventional chest radiography in identifying traumatic intrathoracic injuries. Objective: To evaluate and compare the accuracy, sensitivity and specicity of chest ultrasound and chest x ray as a diagnostic tool in detection of pneumothorax, in trauma patients using CT thorax as gold standard. Study design: Descriptive study. Place and duration of study :Department of General Surgery, Lala Lajpat Rai Hospital, GSVM Medical College, Kanpur, UP, India, between December 2020 to October 2022. Methodology : In the present descriptive study, patients with traumatic intrathoracic injuries, who were referred to the emergency department between December 2020 to October 2022, were assessed. The patients underwent bedside chest ultrasound (USG), x ray and computed tomography (CT) scan examinations based on ATLS recommendations. Results : Eighty ve patients with mean age 41.13 ± 17.2 ( range 7-87 ) were taken (68.24 % males ).CT scan showed pneumothorax, in 94.12 %, cases Whereas chest ultrasonography in comparison to radiography detected pneumothorax in 69.41 % respectively. Comparison of sensitivity, specicity, positive predictive value and negative predictive value after taking CT thorax as gold standard gave accuracy of 76.27 % to USG thorax and 50.85 % to chest x ray (p =0.0005 )for detecting pneumothorax , Conclusions : The results of the present study showed that ultrasonography is preferable to radiography in the initial evaluation of patients with traumatic injuries to the thoracic cavity.