Comparison of Chest X-Ray and Lung Ultrasound for Diagnosing Community-Acquired Pneumonia in Children

Authors

  • Harivignesh
  • Hemanth Mogili

Keywords:

Community-acquired pneumonia; lung ultrasound; chest X-ray; paediatrics; pulmonology

Abstract

 Background: Community-acquired pneumonia (CAP) remains a leading cause of childhood morbidity. Chest X-ray (CXR) is the standard imaging modality but involves ionising radiation. Lung ultrasound (LUS) is a radiation-free alternative. This study compared the diagnostic accuracy of LUS versus CXR for paediatric CAP.

Methods: A prospective study was conducted on 150 children (aged 6 months to 12 years) with suspected CAP between January and March 2025. All children underwent both CXR (interpreted by a paediatric pulmonologist) and LUS (interpreted by a paediatrician) within 4 hours of presentation. The reference standard was a clinical diagnosis confirmed by follow-up at 14 days. Sensitivity, specificity, and inter-observer agreement were calculated.

Results: The prevalence of CAP was 72% (108/150). Lung ultrasound demonstrated sensitivity of 94.4% (95% CI: 88.1–97.9%) and specificity of 90.5% (95% CI: 77.9–97.4%) for diagnosing CAP. Chest X-ray showed sensitivity of 90.7% (95% CI: 83.4–95.5%) and specificity of 92.9% (95% CI: 80.5–98.5%). The difference in sensitivity was not statistically significant (p=0.21). Inter-observer agreement was substantial for LUS (κ=0.77) and almost perfect for CXR (κ=0.84). Ultrasound identified pleural effusions in 12 children (8%) that were missed on initial CXR.

Conclusions: Lung ultrasound has comparable diagnostic accuracy to chest X-ray for paediatric community-acquired pneumonia and offers the advantages of no radiation, lower cost, and bedside availability. Lung ultrasound should be considered as the first-line imaging modality for suspected CAP in children.

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References

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Published

2025-03-07

How to Cite

1.
Harivignesh H, Mogili H. Comparison of Chest X-Ray and Lung Ultrasound for Diagnosing Community-Acquired Pneumonia in Children. J Neonatal Surg [Internet]. 2025 Mar. 7 [cited 2026 May 31];14(3S):220-9. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10231

Issue

Vol. 14 No. 3S (2025): Special Issue: Surgical Interventions and Sports & yoga therapy: Towards Multidisciplinary Approach

Section

Original Article

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