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Left Intercostal Oblique Ultrasound View
Aka: Left Intercostal Oblique Ultrasound View, Left Coronal Ultrasound View
- See Also
- FAST Exam
- Subcostal Echocardiogram View (Subxiphoid Echocardiogram View)
- Right Intercostal Oblique Ultrasound View
- Right Coronal Ultrasound View
- Left Intercostal Oblique Ultrasound View
- Left Coronal Ultrasound View
- Suprapubic Ultrasound View (Long Axis or Longitudinal View)
- Lung Ultrasound for Pneumothorax (Sliding Lung Sign, Lung Point)
- Emergency Echocardiography
- Ultrasound
- Precautions
- Left Pleural Effusion is often missed on FAST Exam
- Do not forget to orient probe superiorly to visualize diaphragm
- Clinically important Pleural Effusions (or Hemothorax) will be clearly seen
- Approach: Left Intercostal Oblique Ultrasound View (LUQ)
- Transducer positioning
- Placement
- Hand resting on bed, holding transducer slightly above plane of bed
- Transducer posiition is at approximately 7th intercostal space
- Axis: Long axis with indicator at 12:00
- May rotate transducer to oblique with indicator towards 1-2:00 to reduce rib shadowing
- Direction: Energy perpendicular to lateral chest towards liver
- Precautions
- Push Knuckles into bed of hand holding transducer
- Most difficult view on the FAST Exam
- Adequate visualization of the Spleen and adjacent structures is challenging
- Transducer needs to be both higher in the chest and more posterior
- Landmarks
- Spleen
- Diaphragm
- Left Kidney may be visible in this view
- Conditions
- Left Hemothorax (same findings as on right)
- Additional measures (if time to evaluate incidental findings)
- Spleen can also be measured for Splenomegaly in this view (normal <12-14 cm)
- Images


- Approach: Left Coronal Ultrasound View
- Obtain view by tilting transducer inferiorly from right intercostal view (or dropping down 1-2 rib spaces)
- Transducer positioning
- Placement: 1-2 interspaces below the Left Intercostal Oblique
- Axis: Long axis with indicator at 12:00
- Direction: Energy perpendicular to lateral Abdomen
- Pan transducer inferiorly to scan the inferior pole of Kidney
- Tilt transducer, sweeping from anterior to posterior Kidney
- Landmarks
- Spleen
- Left Kidney
- Left Psoas Muscle
- Conditions
- Blood superficial to Spleen or around splenic margins (most important to visualize)
- Blood may also collect between Spleen and left Kidney (but this is not typical)
- Blood in left Paracolic Gutter (between left Kidney and psoas Muscle)
- Images


- Resources
- FAST Exam LUQ (Dr. Mandavia, Sonosite)
- http://www.youtube.com/watch?v=VBHCmw8iHCc
- References
- Reardon (2016) FAST Scan, Online Video Stabroom.com, accessed 4/1/2016
- Reardon (2013) Emergency Ultrasound Course, 3rd Rock Ultrasound, Minneapolis, MN
- Alameda County Trauma Service FAST Exam
- http://eastbay.surgery.ucsf.edu/eastbaytrauma/Protocols/ER%20protocol%20pages/FAST-files/FAST.htm
- Mateer (2012) Introduction to Trauma Ultrasound Video, GulfCoast Ultrasound, VL-95-T
- https://www.gcus.com/products/about.asp?product=338/Introduction-to-Trauma-Ultrasound
- HCMC FAST Exam
- http://vimeo.com/1044031