Pneumothorax Following Acupuncture

Abstract

Pneumothorax, the accumulation of air between the visceral and parietal pleurae, represents a potentially serious cause of chest pain in patients presenting to the emergency department. While there are known risk factors for spontaneous pneumothorax, in rare cases dry needling and acupuncture, forms of complementary and alternative medicine, have been known to result in pneumothorax. We present a case of a 38-year-old healthy female who presented with acute onset of pleuritic chest pain to the Emergency Department. On further history, it was discovered that she had received dry needling acupuncture for unrelated back pain the day prior to presentation. She was initially investigated with an electrocardiogram (ECG), which was unremarkable, and point of care ultrasound (POCUS), which showed absent lung sliding and the presence of a lung point on the right side, indicative of pneumothorax. This case describes the key features of pneumothorax on POCUS and how POCUS can be a valuable tool in the diagnosis of lung pathologies and highlights the importance of considering the rare but potentially serious complications of complementary and alternative medicine practices which are typically regarded as safe.

Keywords: pneumothorax (ptx); point-of-care-ultrasound; thoracic imaging; ultrasound (u/s).

Figure 1. Posteroanterior (PA) chest X-ray demonstrating the presence of a right-sided pneumothorax (PN)