Two cases of difficult to detect CXR pathologic signs managed by chest US. Patient A: On the left: CXR reported difficult-to-detect pulmonary consolidation of the left lower lobe consistent with retrocardiac pneumoniax. In the middle: The ultrasound assessment with linear array probe shows delimitated subpleural hypoechoic solid structures surfacing in pleura. Focal pulmonary edema related to inflammatory effects is found near lung consolidations. These findings are associated with small lung consolidations consistent with pneumonia. On the right: Normalized Chest US pattern after therapy. Patient B: CXR performed in anterior-posterior (at top left) and lateral scans (at bottom left) did not show easily detectable pathologic findings. In the middle: The ultrasound assessment with convex probe showed focal echographic interstitial syndrome and focal alterations of the pleural line of a limited dorsal region of the left lower lobe (at top). A minimal free flowing left pleural effusion, limited to costo-phrenic sinus same-sided with the focal echographic interstitial syndrome (at bottom). On the right: Visualization of curtain sign on spleen without evidence of pleural effusion after therapy.