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Chest pain is an alarming symptom and one of the most frequent causes of access to the Emergency Departement. Although chest X-ray remains an essential step in the diagnostic process, several studies showed numerous limitations of radiography which frequently is inconclusive. Ultrasonography is a non-radiating imaging technique. Albeit a wide use of ultrasound, the utilization of ultrasound in the study of the lung has only recently been introduced in the clinical practice. Several studies proved that lung ultrasound is useful in the diagnosis of lung consolidation in community acquired pneumonia. Nowadays, ultrasound is not routinely used in the presence of chest pain. Our hypothesis based on clinical experience is that, in patients with pleuritic chest pain, lung ultrasound is very sensitive in detecting pneumonia and other lung diseases (such as pneumothorax) thus performing better than radiography. The primary aim of this study is to verify, in patients affected by pleuritic chest pain, the accuracy of lung ultrasound compared to chest-X-ray. The secondary aim is to evaluate the accuracy of lung ultrasound consolidations in distinguishing lung consolidation in pneumonia, atelectasis, pulmonary infarction, or tumors.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with pleuritic chest pain | Study investigators will perform lung ultrasound in each patient with pleuritic chest pain at inclusion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lung ultrasound | Procedure | Lung ultrasonography performed and interpreted by a physician (Pulmonologist or Emergency Physician) possessing specific knowledge in the procedure and a training of at least 100 thoracic ultrasonographies in accordance to a prespecified protocol. |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity and specificity of lung ultrasound in pneumonia, chest wall pain, lung cancer, pulmonary embolism or other causes in patients presenting with pleuritic chest pain. | Sensitivity and specificity, positive and negative predictive values of lung ultrasound in pneumonia, chest wall pain, lung cancer, pulmonary embolism or other causes in patients presenting with pleuritic chest pain. | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of ultrasound in distinguishing lung consolidation in pneumonia, atelectasis, pulmonary infarction or tumors | Accuracy of ultrasound in differentiating consolidation in distinguishing lung consolidation in pneumonia, atelectasis, pulmonary infarction, tumors or other diseases with respect to the final diagnosis stated by a scientific committee. | 30 days |
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Inclusion Criteria:
Exclusion Criteria:
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Inpatients and outpatients presenting with pleuritic chest pain referred for medical consultation to italian university and clinical hospitals.
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| Name | Affiliation | Role |
|---|---|---|
| Giuseppe Francesco Sferrazza Papa, M.D. | Respiratory Unit, San Paolo Hospital, Dipartimento Scienze della Salute, Università degli Studi di Milano, Milan, Italy. | Principal Investigator |
| Stefano Centanni, M.D, Ph.D. | Respiratory Unit, San Paolo Hospital, Dipartimento Scienze della Salute, Università degli Studi di Milano, Milan, Italy. | Study Chair |
| Giovanni Volpicelli, M.D. | Emergency Medicine staff Physician San Luigi Gonzaga University Hospital Torino, Italy. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Emergency Department, Azienda Ospedaliera Universitaria Careggi, Firenze. | Florence | Italy | ||||
| USC Pneumologia, Azienda Ospedaliera della Provincia di Lodi |
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| ID | Term |
|---|---|
| D000098968 | Community-Acquired Pneumonia |
| D010998 | Pleurisy |
| D011655 | Pulmonary Embolism |
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D017714 | Community-Acquired Infections |
| D007239 | Infections |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
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|
| Lodi |
| Italy |
| - U.O.C Broncopneumologia, IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano. | Milan | Italy |
| Emergency Department, San Paolo Hospital | Milan | Italy |
| Respiratory Unit, San Paolo Hospital, Dipartimento Scienze della Salute, Università degli Studi di Milano. | Milan | Italy |
| S.O.C. Pneumologia, Ospedale S. Luca, Rovigo. | Rovigo | Italy |
| - Dipartimento di Medicina d'Urgenza, Ospedale Universitario, S. Luigi Gonzaga, Orbassano (TO). | Turin | Italy |
| D012140 |
| Respiratory Tract Diseases |
| D010995 | Pleural Diseases |
| D008171 | Lung Diseases |
| D004617 | Embolism |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |