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Table 6 The lung signs matrix

From: Lung ultrasound—a primary survey of the acutely dyspneic patient

Diagnosis Lung signs distribution Lung sliding Pleural line B-lines Effusion Consolidation
Acute pulmonary oedema/fluid overload states Bilateral/symmetrical Present Normal Bilateral/symmetrical Often present No
Acute respiratory distress syndrome Bilateral/asymmetrical/patchy Present/may be absent in severe states Thickened/uneven Patchy distribution May be found Yes
Bacterial pneumonia Usually unilateral/focal/patchy Present/may be absent in severe states Thickened/uneven Focal May be found/empyema Yes
Viral/atypical pneumonia Bilateral/asymmetrical/patchy Present/may be absent in severe states Thickened/uneven Patchy distribution May be found Yes
Acute interstitial lung disease Bilateral/asymmetrical/patchy Present/may be absent in severe states Thickened/uneven Patchy distribution May be found Yes
Pneumothorax Focal/starts with upper lung Absent Normal No No No
COPD exacerbation/asthma Present Normal No No No
Acute pulmonary infarction Focal Present/may be absent Normal/may be thickened No May be found Yes—at late stage
Atelectasis Focal Absent Normal No May be found Yes—at late stage