A 60-something year-old patient presents with acute dyspnea. There’s a history of coronary artery disease and and end stage renal disease.
As part of the initial evaluation a POCUS Thoracic shows a unilateral ‘spine sign’ representing a pleural effusion. Above (cephalad) to the diaphragm you see the thoracic spine as a horizontally oriented bright white (hyperechoic) somewhat bumpy appearing line. On the left of the screen you see lung parychema bathed in anechoic (black) pleural fluid. This unilateral pleural effusion was drained with resulting symptomatic improvement.
Pearls: If you’re not already, give the Triple Scan [PMID: 26823930] a try to see if it improves diagnostic accuracy for for your next patient with undifferentiated dyspnea.