Why look for artifacts alone when the original is visible? If Dr Mathis understands anatomic images (pleural-based consolidations) to be original, we answer: because the original is not so original. These lesions are usual in most cases of acute respiratory failure (see our response to Drs Reissig and Kroegel). In addition, in the case of an A-profile, typically there is no original. Dr Mathis’s remark is untrue. We use both artifacts and anatomic data, according to the profiles. For pulmonary edema, only anterior artifacts are necessary. For certain pneumoniae, the diagnosis is based on anterior artifacts plus posterior lesions. Regarding their comment that further abbreviations would make decision trees complex, for nearly 20 years the main artifacts have been A-lines and B-lines, so it is unlikely that new signs, merging from observation, decrease lung ultrasound simplicity.