Comparison of FAST and chest X-ray for diagnosis of pneumothorax in traumatic patients

Objective: In this study, to compare FAST ultrasound with anterior-posterior (AP) chest radiography (CXR) for diagnosing pneumothorax in blunt trauma patients. Methods: This study was conducted cross-sectionally. The sampling method was convenient. 100 trauma patients were included in the study based on the inclusion criteria at Shahid Madani Training-Therapeutic Center during 2020-2021. Information from FAST ultrasound, chest radiography, and computed tomography (CT) scans of patients was collected. CT scan results were compared to the results of ultrasound and radiography as the gold standard for diagnosing pneumothorax. Data were analyzed using SPSS v22 and Med-Calc v20. McNemar’s test compared diagnostic accuracy (sensitivity/specificity/PPV/NPV), while independent t -tests analyzed continuous variables. Statistical significance was set at P < 0.05, with 95% CIs for all measures Results: The sensitivity of AP radiography and FAST ultrasound of the chest for diagnosing pneumothorax compared to CT scan were 78.26% and 95.65%, respectively. The sensitivity of AP radiography and FAST ultrasound were 78.26% and 95.65%, respectively. Specificity values were 100% for both modalities when compared to CT scan as the gold standard. Conclusions: This study demonstrates that FAST ultrasound offers superior sensitivity (95.7%) compared to AP radiography (78.3%) for pneumothorax detection in non-penetrating chest trauma. However, its reliability may be influenced by operator dependency and convenience sampling limitations. While these findings support FAST ultrasound as a valuable bedside tool, multicenter trials with standardized protocols and multiple operators are needed to confirm generalizability.