Do not prescrive chest x-ray for diagnosis and follow-up of uncomplicated pneumonia in children
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.
1. Poutanen R, Virta T, Heikkilä P et al. National Current Care Guidelines for paediatric lower respiratory tract infections reduced the use of chest radiographs but local variations were observed. Acta Paediatr 2020;00:1–7. https://doi.org/10.1111/apa.15692
2. Sherwin S. Chan,Manish K. Kotecha,Cynthia K et al. ACR Appropriateness Criteria® Pneumonia in the Immunocompetent Child. J Am Coll Radiol 2020;17(5S):S215-S225. doi: 10.1016/j.jacr.2020.01.033.
3. Andronikou, S, Lambert E, Halton, J et al. Guidelines for the use of chest radiographs in community-acquired pneumonia in children and adolescents. Pediatr Radiol 2017;47:1405–11. https://doi.org/10.1007/s00247-017-3944-4
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.