Thoracic Ultrasound in Pleural Effusion: A Bedside Practical Approach Introduction.

Pleural effusion is a common clinical problem, and bedside imaging plays a central role in its timely evaluation and management. In our prior companion articles, we outlined the clinical approach to pleural disease and the role of pleural fluid analysis. In this article, we describe how thoracic ultrasound (TUS) is incorporated into routine pleural practice. The value of TUS extends well beyond procedural guidance. TUS is routinely used to characterize pleural effusion, identify pleural and parenchymal abnormalities, refine the differential diagnosis, and guide appropriate pleural procedures. We present a practical approach to image acquisition, interpretation, and clinical decision-making at the bedside. We also review common pitfalls, limitations, and safety considerations that are important to everyday practice. Our goal is to provide clinicians with a structured approach for using TUS in the assessment and management of pleural effusions.