6
EASy MAPLeft Pleural
View 6 · probe position F · left posterior axillary line
Machine setup
- Same sector probe; wipe excess gel off the chest wall and re-gel.
- Adult Cardiac preset, B-mode, marker upper right.
- Depth stays at 21 cm — the same depth for all six views; it carries the spine onto the bottom of the screen.
- Gain set so the splenic parenchyma is mid-grey and the diaphragm reads bright.
Acquire
- Place the probe at the left posterior axillary line, in the same horizontal plane as the subcostal cardiac view, marker at 12 o'clock.
- Identify the spleen. If gastric air or anatomy obscures it, slide posteriorly as far as the table and chest wall allow and find the left kidney, which generally lies inferior to the spleen.
- Identify the left hemidiaphragm superior to the spleen — a bright hyperechoic line, as on the right.
- Angle the tail anteriorly to bring in the spine, then identify the lung sweeping its shadow with inspiration.
Pitfalls
- Gastric air read as consolidation — reposition posteriorly and re-identify the spleen.
- Staying too anterior: the splenic window is higher and more posterior than the hepatic one.
- Pressing harder instead of moving posteriorly when the window is poor.
- Calling the exam done before all six views are recorded; the last view still changes the presumptive diagnosis.
Confirm before you record
Spleen, diaphragm, spine and lung all in view simultaneously, then record. The splenic window is smaller than the hepatic one — expect to work harder for it, and go posterior rather than pressing harder.
Read it
- Pleural effusion or hemothorax — note loculations.
- Consolidation, directly or via the spine sign / lost airspace curtain.
- Compare with the right: a unilateral effusion changes the differential.
What this view adds
The last piece of the sweep. Read all six together — heart, IVC, lung, pleura — to name the predominant physiology, then treat that one driver and reassess.