What do you think about using conventional thoracic imaging methods (e.g., X-ray, CT, etc.) to determine if a pleural effusion is of adequate size to consider thoracentesis?

Generally speaking, CT would be superior as it would allow you to see more volumetric characteristics of the effusion; XR would have a hard time discerning true size, presence of loculations, or trapped lung.

The real winner for this application would be bedside ultrasound. This modality would give ...

Imaging pleural effusion by chest radiograph is certainly the most common imaging modality we learn in training. Less advertised is the fact that the sensitivity and specificity are not perfect (53% for small effusions in one study) and they are known to miss effusions where there is lower lobe cons...

ACR Appropriateness Criteria® is a very good source to learn about the best imaging study.

Appropriateness Criteria

Workup of Pleural Effusion or Pleural Disease

In my personal experience, most of the time, CT is my best friend.

The most common cause of pleural effusion we see in the hospital is acute d...

I have used standard ultrasound technology since 2000 for most of my thoracenteses. Success is high. Complications are low.

Patient comfort, diagnostic success, and the ability to eliminate complications are the key factors.