Among the several signs of pneumothorax on lung ultrasound (LUS), a definite one is the presence of the lung point, which is observed as the contact between the sliding and non-sliding lung (Video 1). There is also an unusual sign of pneumothorax, which is called the “hydro-point”, as depicted in a 70-year-old male patient with COVID-19 pneumonia. Here, the air in the pleura (pneumothorax, arrows) contacts intermittently with the pleural fluid (pleural effusion, asterisks) within the respiratory cycles (Fig. 1a; L: lung consolidation and Video 2). Chest X-ray showed a similar picture (Fig. 1b). The hydro-point defines the presence of hydropneumothorax and is best assessed with a convex or phased-array probe in basal lateral or posterolateral views of the thorax. Intensivists should be aware of this sign to aid in diagnosis of pneumothorax in the presence of pleural effusion.

Figure 1

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