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Review
. 2014 Dec 1;5(Suppl 1):38-51.
doi: 10.15172/pneu.2014.5/482. eCollection 2014.

The radiological diagnosis of pneumonia in children

Kerry-Ann F O'Grady  1 , Paul J Torzillo  2   3 , Kieran Frawley  4 , Anne B Chang  1   5   6
Affiliations
Review

The radiological diagnosis of pneumonia in children

Kerry-Ann F O'Grady et al. Pneumonia (Nathan). .

Abstract

Despite the importance of paediatric pneumonia as a cause of short and long-term morbidity and mortality worldwide, a reliable gold standard for its diagnosis remains elusive. The utility of clinical, microbiological and radiological diagnostic approaches varies widely within and between populations and is heavily dependent on the expertise and resources available in various settings. Here we review the role of radiology in the diagnosis of paediatric pneumonia. Chest radiographs (CXRs) are the most widely employed test, however, they are not indicated in ambulatory settings, cannot distinguish between viral and bacterial infections and have a limited role in the ongoing management of disease. A standardised definition of alveolar pneumonia on a CXR exists for epidemiological studies targeting bacterial pneumonias but it should not be extrapolated to clinical settings. Radiography, computed tomography and to a lesser extent ultrasonography and magnetic resonance imaging play an important role in complicated pneumonias but there are limitations that preclude their use as routine diagnostic tools. Large population-based studies are needed in different populations to address many of the knowledge gaps in the radiological diagnosis of pneumonia in children, however, the feasibility of such studies is an important barrier.

Keywords: children; diagnosis; pneumonia; radiology; utility.

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Figures

Figure 1
Figure 1
Chest radiograph showing right lower lobe pneumonia
Figure 2
Figure 2
Chest radiograph showing interstitial infiltrates
Figure 3
Figure 3
Example of chest radiograph discordant for the diagnosis of pneumonia between a paediatric pulmonologist and WHO radiological criteria when applied in the clinical context. Note: Chest radiograph of left upper lobe pneumonia diagnosed by a paediatric pulmonologist in a 12 month old child hospitalised for pneumonia. Clinical signs of tachypnoea, chest-indrawing and crackles on admission. This film was classified as negative according to WHO radiological criteria.
See this image and copyright information in PMC

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