I read with interest the study by Sekiguchi et al in a recent issue of CHEST (October 2015) that focused on combined cardiac and lung ultrasound to evaluate the etiology of acute hypoxic respiratory failure. The authors reported good diagnostic utility in differentiating ARDS from cardiogenic pulmonary edema (CPE) by evaluating the amount of left pleural effusion, the severity of left ventricular dysfunction, and the diameter of the inferior vena cava. In the Supplemental Materials section of the online article, the authors describe that both C (consolidative)-pattern and pleural effusion were assessed in examination point 5 (posterolateral zone of the lung), but only data regarding pleural effusion were reported in e-Table 1. Whether posterior consolidation exists may be important in differentiating ARDS from CPE. Copetti et al identified consolidation by using lung ultrasound in 83% of patients with ARDS but in no patients with CPE. In contrast, posterior consolidation and/or atelectasis have been known to be a classic finding in ARDS, documented by using CT scan results. In a study evaluating lung ultrasound for the assessment of lung recruitment in patients with ARDS, Bouhemad et al also reported that consolidation was the predominant ultrasound pattern in the lower part of the posterior thoracic region. Could Sekiguchi et al provide the detailed information about the ultrasound pattern in examination point 5, especially the consolidation pattern?