A 45-year-old female presented to the family medicine clinic with a history of fever, chest pain and dyspnea for 7 days. The physician performed a physical exam and then proceeded to perform a POCUS lung examination obtaining the image below.
Which of the sonographic findings is seen?
A. Air bronchograms
B. Jellyfish sign
C. Barcode sign
Air bronchograms are observed.
Explanation
When the alveoli are filled with fluid/secretions, the affected lung area can be seen on ultrasound as the fluid/secretions allow the ultrasound beam to travel through it. If the bronchial tree still has air in it then we see echogenic areas within the lung parenchyma. These are known as sonographic air bronchograms. These could be tiny punctate lesions or could be longer and linear. If the air bronchogram is not moving during respiration it is known as a static air bronchogram. This indicates the presence of trapped air and is consistent with resorptive atelectasis. However, if the echogenic air bronchogram is moving with respiration, then it indicates the presence of a non-retractile consolidation and is known as a dynamic air bronchogram and is most probably due to a pneumonia (94% specificity).
References
- Koratala, A. Pneumonia and dynamic air bronchograms. NephroPOCUS. Published July 1, 2019. Accessed January 7, 2022. https://nephropocus.com/2019/07/01/dynamic-air-bronchograms-ultrasound-sign-of-pneumonia/
