Gregory P. Blair, MD
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Blair G.; Routine Chest Radiography after Thoracentesis. Ann Intern Med. 1997;126:491. doi: 10.7326/0003-4819-126-6-199703150-00015
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Published: Ann Intern Med. 1997;126(6):491.
TO THE EDITOR:
Doyle and associates  reported on the necessity of routine chest radiography after thoracentesis. They use as their sole indicator the suspicion that a pneumothorax may have occurred as a result of the procedure. Using their criteria of obtaining a post-thoracentesis chest radiograph, they concluded that at least 60% of post-thoracentesis chest radiographs could be avoided. However, it is erroneous to believe that the only reason to obtain a post-thoracentesis chest radiograph is to check for such complications as a pneumothorax.
In truth, the post-thoracentesis chest radiograph can add valuable information, such as the appearance of the underlying lung and pleura that had previously been obscured by the pleural effusion. In addition, the radiograph can give information on how well the pleural space has been evacuated and can act as a baseline for determining how rapidly the pleural fluid returns. The latter can have significant diagnostic and therapeutic implications for the future. For these reasons, I believe that Doyle and colleagues' report may have significantly understated the value of post-thoracentesis radiography.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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