standards were included computed tomography (CT) and a composite of clinical presentation and escape/aspiration of intrapleural air on

drainage [12]. Though not used prevalently in clinical practice, in cases where patient's clinical manifestations cannot be elucidated using
PACX or in conditions where clinical suspicion persists lateral chest ra- diograms, PACX obtained during expiration and supine decubitus
radio- grams have been used [1]. However it has been demonstrated that in the establishment of the diagnosis of pneumothorax PACX
obtained during expiration does not confer additional benefit to those gained by PACX taken during inspiration [13,14]. Despite lower
exposure to ra- diation and cost, obviously chest radiograms have lower selectivity rates in the diagnosis of pneumothorax.

Use of the chest CT which is the gold standard for the diagnosis of pneumothorax is not recommended as a first-line imaging modality in
guidelines, because of radiation exposure and high cost physicians do not favour its use [1,3]. In meta-analyse performed, it has been stated
that although lung ultrasound has higher diagnostic sensitivity (88%) and specificity (99%) relative to chest X-rays, lung ultrasound still
lacks adequate sensitivity [12]. Nevertheless four point lung ultrasound (sensitivity 93.3%, specificity 98%) were found better than X-ray in
con- ventional supine position (sensitivity 48%, specificity 100%) for diagno- sis of clinically significant pneumothorax in a randomized
prospective