Ultrasonography effective for diagnosing childhood pneumonia

Dec 11 2012

By Helen Albert, Senior medwireNews Reporter

Point-of-care ultrasound scanning can be used to diagnose pneumonia accurately in children and young people, show study findings.

Researchers led by James Tsung, from Mount Sinai School of Medicine in New York, USA, hope that their findings could help diagnose children with pneumonia in developing countries, where deaths from the disease are particularly high.

"The World Health Organization has estimated as many as three-quarters of the world's population, especially in the developing world, does not have access to any diagnostic imaging, such as chest X-ray, to detect pneumonia," said Tsung in a press statement.

"Many children treated with antibiotics may only have a viral infection - not pneumonia. Portable ultrasound machines can provide a more accurate diagnosis of pneumonia than a stethoscope."

Tsung and colleagues enrolled 200 patients under the age of 21 years to take part in their study. All patients had suspected community-acquired pneumonia and all diagnoses were checked using chest radiography.

The clinicians involved in the study had 1 hour of focused training in ultrasonography to diagnose pneumonia in children and young people.

As reported in the Archives of Pediatric and Adolescent Medicine, the patients were aged a median of 3 years and chest radiography diagnosed pneumonia in 18% of the group.

Ultrasonography, involving visualization of lung consolidation with sonographic air bronchograms, accurately diagnosed pneumonia in the majority of cases, with a sensitivity of 86%, a specificity of 89%, a positive likelihood ratio (LR) of 7.8, and a negative LR of 0.2.

In patients with lung consolidation of over 1 cm, point-of-care ultrasound was even more accurate, with a sensitivity of 86%, specificity of 97%, positive LR of 28.2, and negative LR of 0.1 for diagnosing pneumonia.

Kassa Darge and Aaron Chen (The Children's Hospital of Philadelphia, Pennsylvania, USA), the authors of an accompanying editorial, say that further studies are needed to confirm these results.

However, they conclude: "In the future, wherever the institutional infrastructure permits, in the diagnostic imaging algorithm for suspected pneumonia in children, ultrasonography may need to precede, augment, or even replace chest radiography."

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