PERCUSSION OF THE STERNUM

The relative advantages of percussion and of single roentgenograms were studied in 32 cases of pericardial effusion. The diagnosis was established by actual demonstration of the presence of effusion fluid by paracentesis, biopsy, autopsy, or serial roentgenograms. The single roentgenogram gave the correct diagnosis in only 13% (4 of 32 cases), but percussion gave the correct diagnosis in 58% (17 of the 29 cases in which adequate records were available). The most reliable sign was a flat percussion sound over the lower half of the sternum; flat percussion sounds in the left third intercostal space adjacent to the sternum and on the right extending from the sternum between the third and sixth ribs were also often observed in this condition. The procedure of percussion can be simplified by fixing attention on areas of flat percussion sounds and disregarding intermediate degrees of dulness.