Aims and objectives
All patients with a suspected pneumothorax,
at the Glasgow Royal Infirmary,
are investigated with both inspiratory and expiratory radiographs.
Our experience is that expiratory radiographs provide little additional benefit to the patient and ensue additional radiation doseas well as increasedepartmental workload and cost. Expiratory radiographs are a historical phenomenon thought to increase detection of pneumothoraces.
A literature review from 1996 to 2016 has uncovered evidence questioning...
Methods and materials
Using our local CRIS we performed a retrospective evaluation all of inspiratory and expiratory pair radiographs taken over a 6 month period from August 2016 to January 2017,
totalling 966 pairs. We analysed the radiographs for pneumothorax and ascertained whether the additional expiratory radiograph provided benefit in the diagnosis of pneumothorax.
In addition we measured the average pneumothorax size.
17 pneumothoraces were detected from the 966 pairs (1.8%). All 17 pneumothoraces were visible on the inspiratory radiograph. The average size of pneumothorax was 3.8cm
Our study showed that we perform approximately 1900 paired radiographs per year.
Despite the large number of examinations performed we foundvery few pneumothoraces (1.7%). None of the expiratory radiographs provided any additional benefit in diagnosis or patient management. Our local study is in keeping with the literature review and suggests we should consider a change of practice to no longer empirically perform expiratory radiographs.
This will reduce radiographic load as well as provide...
Pernicano PG et-al.
Comparison of upright inspiratory and expiratory chest radiographs for detecting pneumothoraces.
AJR Am J Roentgenol.
1996;166 (2): 313-6.
AJR Am J Roentgenol Schramel FMNH,
Diagnosis of pneumothorax not improved by additional roentgen pictures of the thorax in the expiratory phase.
Ned Tijdschr Geneeskd 1995;139:131e3 Schramel FM,
Expiratory chest radiographs do not improve visibility of...