Clinical diagnosis of pneumonia in children is possible, according to guidelines that limit the use of chest X-rays to well-defined particular conditions. More generally, in clinical practice, the execution of any diagnostic procedure (lab or instrumental evaluations) should always be motivated by the need to acquire essential information to guide the management of a problem. However, in daily clinical practice, it often happens that “control” investigations are carried out without a real practical need, with a waste of energy and time and possible risks for the patient. The accurate anamnestic, clinical and epidemiological evaluation and the clear and complete confrontation with the patient and parents are the basis both for a correct approach and optimal results by the selection of the most appropriate procedures. In some socio-health risk settings (eg immigrant children from areas with a high prevalence of tuberculosis) it is possible to consider, in selected cases, the execution of chest X-rays as part of specific examinations.

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