5. Major Lung Ultrasound Pathology Profiles


Pneumonia is an infection that inflames the alveoli and fills them with fluid. This extra fluid creates unilateral or bilateral B-lines depending if one or both lungs are affected.

The fluid or pus-filled alveoli also cause a productive cough with colored phlegm, fever, chills, and difficulty breathing.

Ultrasound Profile of Pneumonia:

  • Shred sign
  • Consolidated lung tissue with dynamic air bronchograms
  • B-lines: unilateral (bacterial) or bilateral (viral)
  • Decreased lung sliding depending on severity
  • Small pleural effusion depending on severity
Confluent B-Lines Lung Ultrasound
Confluent B-lines
Dynamic Air bronchogram Lung Ultrasound
Consolidation with Dynamic Air Bronchogram
Lung Consolidation Ultrasound
Consolidated Lung

Even the most experienced ultrasound practitioners have difficulty distinguishing pneumonia from atelectasis using ultrasound alone. Thus, a clear clinical picture is necessary before determining the true cause of lung consolidation. The table below outlines some of the key differentiating factors between pneumonia and atelectasis.

US Findings– Consolidation pattern
– Shred sign
– Dynamic bronchograms
– Possible pleural effusion (parapneumonic effusion)
– Consolidation pattern
– Static air bronchograms
Distinguishing clinical features– Fever and chills
– Cough with colored mucous or blood
– Severe Malaise
– Crackles and breath sounds
– Obstruction to airway
– Acute dyspnea
– Mucous plug in Bronchus

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