Narrative review of chest wall ultrasound: a practical approach

Abstract

Background and Objective: Traditionally, literature on thoracic ultrasound has focused on the study of pleural and pulmonary pathology. However, given the superficial location of thoracic wall structures, ultrasound proves to be an excellent technique for their examination. This study aims to evaluate the clinical utility of thoracic ultrasound in diagnosing various thoracic wall pathologies and to illustrate the primary diagnoses that can be achieved. Methods: We performed a literature search in January 2024 in PubMed and Google Scholar for articles on thoracic ultrasound. Relevant articles were selected and synthesized in a narrative form. Key Content and Findings: Thoracic ultrasound has emerged as a powerful diagnostic tool, especially when combined with a thorough clinical history. It allows for rapid, inexpensive, and safe resolution of a wide range of common clinical uncertainties across all levels of healthcare. In emergency contexts, it excels in the detection of rib fractures, demonstrating superior capability compared to traditional chest X-rays and similar efficacy to computed tomography (CT) scans. Additionally, thoracic ultrasound is highly effective in evaluating tumors, often providing accurate diagnoses without the need for further studies. It also aids in differentiating pathologies that may require more advanced imaging such as CT or magnetic resonance imaging (MRI). Moreover, thoracic ultrasound plays a valuable role in the initial assessment of infectious and degenerative conditions. Conclusions: Thoracic ultrasound is a versatile and efficient diagnostic tool for examining thoracic wall structures. Its applications are particularly valuable in trauma assessment, tumor evaluation, and the differentiation of various pathologies. The rapid, cost-effective, and safe nature of this technique highlights its potential as a primary diagnostic tool in a wide variety of clinical settings.