The role of chest ultrasound in the diagnosis of thoracic tuberculosis

Introduction Data regarding the role of chest ultrasound (CUS) in thoracic tuberculosis (TTB) are deficient. If the diagnostic accuracy of CUS for pulmonary tuberculosis (PTB) is similar to that for CUS in the diagnosis of pneumonia, CUS could play an important role in its diagnosis. Aim This study aimed to describe the diagnostic features and use of CUS in TTB and compare CUS findings in PTB versus community-acquired pneumonia (CAP). Patients and methods Consecutive patients presenting with TTB and CAP were enrolled in this study. Computed tomography (CT) chest, CUS, mediastinal US, and abdominal US were performed. CUS lesion pattern in TTB, PTB, and CAP cases were recorded. Results CUS in patients with PTB uniquely and significantly detected pleural gap (28 patients, 27%), fragmented pleura (35 patients, 34%), subpleural fluid collection (three patients, 2.9%), and subpleural nodules (SPN) (97 patients, 95%), which were not detected by CT (P<0.05 for all). Moreover, CUS in patients with PTB uniquely and significantly detected absent sliding sign in a cavitary lesion, pleural gap, and SPNs, which were absent in CUS in CAP (P<0.05 for all) and highly significant more subpleural consolidations when compared with CUS findings in CAP. However, more significant air bronchogram CUS patterns were encountered in patients with CAP than in those with PTB. Conclusion CUS is a complementary tool in assessing TTB. It can report new PTB patterns (pleural gap, fragmented pleura, subpleural fluid collection, SPN, and subpleural consolidation) not detected by CT. CUS detects different sonographic patterns in PTB than CAP.