[Critical care ultrasound of the thorax - what is the procedure?]

Despite the limitations (especially that ultrasound does not penetrate air containing lung tissue) ultrasound of the thorax is a very suitable method as a complementary or even primary diagnostic tool. Bedside availability and no radiation exposure are real advantages. However we always have to keep in mind that we are blind for deeper lung processes that do not have contact to the visceral pleura.This article illustrates where and how to look for pathologies and what we have to expect in patients. According to symptoms such as dyspnea, dyspnea with fever and thorax pain with and without trauma, the sonographic morphology of important illnesses in emergency situation are described. The use of ultrasound can help to distinguish between differential diagnosis such as acute exacerbation of COPD vs. heart failure, pleuritis vs. pulmonary embolism, rip fracture vs. "simple" bone contusion and blunt chest trauma with or without pneumothorax.