Lung ultrasound is chest x-ray’s equal in diagnosing pediatric pneumonia

Children with suspected pneumonia are well served when imagers choose lung ultrasound over chest x-ray for primary evaluation, as the radiation-free modality is safe, highly accurate and readily available in many emergency care settings.

That’s according to a study running in the March edition of the journal Chest.

Examining 191 pediatric patients presenting with pneumonia symptoms in the ED, James W. Tsung, MD, MPH, and colleagues at Mount Sinai Hospital in New York City randomly built an investigational group of patients who received ultrasound first and were only given a verifying x-ray in cases of clinical uncertainty.

A control group received a chest x-ray followed by a lung ultrasound.

The investigators recorded zero cases of missed pneumonia—and no adverse events or unscheduled follow-up visits—among all study participants.

In addition, the team recorded a 38.8 percent reduction in chest x-rays in the investigational group, with experienced clinician-sonologists achieving a 60.6 percent reduction and novices achieving a reduction of 30 percent.

There was no x-ray reduction in the control group.

Mount Sinai has posted a short, consumer-friendly video to YouTube. It features Tsung, an associate professor of pediatrics and emergency medicine at the Icahn School of Medicine, discussing the study.

“Ultrasound is portable, cost-saving and safer for children than an x-ray because it does not expose them to radiation,” Tsung says. “Our study could have a profound impact in the developing world where access to radiography is limited.”

To view the video, click here.