[page 6] [Emergency Care Journal 2013; 9:e3]

Spontaneous pneumothorax is a relatively common disease but its radiological diagnosis can be difficult because of the insufficient sen-sitivity of chest X-rays. This is even more so when bullous emphysema and acute pneu-mothorax co-exist. There is evidence that lung ultrasound is a valid instrument to detect a pneumothorax and a valid help in the differen-tial diagnosis between pneumothorax and pul-monary blebs. We present a case which sug-gests the potential superiority of lung ultra-sound on chest radiography in distinguishing free air (pneumothorax) from apical blebs, particularly when these are located in the pos-terior regions and may be easily confused with pneumothorax