Diagnostic utility of transthoracic ultrasound in chest trauma versus chest radiography

Abstract

The general objective: To determine the diagnostic utility of transthoracic ultrasound in comparison with chest x-ray in patients with thoracic trauma in the surgical emergency of the Central Hospital of Maracay during the period 2023-2024. Materials and Methods: A quantitative research was carried out under the clinical-epidemiological modality of descriptive, non-experimental, observational, prospective and longitudinal type. The study population consisted of 32 patients over 10 years of age, of both sexes, with chest pain and diagnosed with thoracic trauma.  Results: The average age of the patients was 38.15 years (±15.27), with a male predominance (84.38%). Most of the patients came from the state of Aragua (71.88%). The most common clinical manifestations were chest pain (100%) and dyspnea (43.75%). The leading causes of trauma included motorcycle-vehicle collisions (25%) and vehicle-to-vehicle collisions (9.38%). Transthoracic ultrasound detected pneumothorax in 28.13% of cases and pleural effusion in 18.75%, with sensitivities and specificities higher than those of chest x-ray. In addition, a high concordance was found in the detection of rib fractures and interstitial patterns. Conclusion: The study demonstrates that transthoracic ultrasound is an effective and superior diagnostic tool compared to chest x-ray for the detection of pulmonary pathologies in patients with thoracic trauma. Its routine implementation in surgical emergencies can significantly improve the diagnosis and management of these injuries, reducing morbidity and mortality. It is recommended that medical personnel be trained in the use of transthoracic ultrasound and consider its integration into trauma management protocols in emergencies.