The Use of Ultrasound in the Diagnosis of Free Pleural Fluid - A Case Study and Literature Review

Introduction: The presence of free pleural fluid is a common cause of dyspnea, particularly in the elderly population with multiple morbidities. There are many causes for this condition, but the most common include heart failure, cancer, lung infections, liver failure, and so on. The most common diagnostic tests for free pleural fluid are X-ray and ultrasonography, and in selected cases, computed tomography. In addition, we present the case of our patient who had a moderate amount of fluid in the pleural cavity, which caused significant clinical symptoms, and who did not consent to undergo an X-ray or CT scan due to his own beliefs. Method: The aim of this paper is to describe our own experience with using ultrasonography in the diagnosis of free pleural fluid and to conduct a literature review using the Pubmed medical database, examining the sensitivity and specificity of ultrasonography in the diagnosis of free pleural fluid and its comparison to X-ray. Results: Based on the conducted studies, it can be concluded that ultrasonography is more effective in the diagnosis of free pleural fluid than X-ray. Furthermore, the advantages of ultrasonography include its wide availability, the lack of ionizing radiation, low diagnostic cost, and the ability to perform the examination at the bedside. Thanks to ultrasound, it became possible to diagnose free fluid and then drain it without the use of radiological methods in accordance with the patient's will. Conclusions: Lung ultrasound is far more sensitive and specific tool in diagnostic of the pleural effusion and significantly increases the safety of invasive therapeutic procedures such as thoracentesis thanks to the possibility of continuous real-time imaging.