Many factors contribute to these differences, including: health systems resourcing, the number of possible causative micro-organisms, host and environmental factors, timing of presentation to a health service, expertise of the health service providers at various levels of the health care system, availability of diagnostic facilities and the absence of a true diagnostic gold standard. ĭespite the commonality of pneumonia in children, disagreement remains about diagnosis in both clinical and research settings. The implementation and effectiveness of the guidelines vary widely within and between countries and, in many regions, improvements are still required in the diagnosis and management of pneumonia at the community level. Early diagnosis and management are critical to short- and long-term health outcomes with several clinical guidelines now available for both developing and developed country settings, albeit with concerns about the inconsistencies between these documents. In addition to the impact of acute disease, respiratory infections (especially when repeated) in young children are associated with long-term lung function abnormality and disease in adults. Pneumonia remains the most important cause of mortality and morbidity in young children globally. Large population-based studies are needed in different populations to address many of the knowledge gaps in the radiological diagnosis of pneumonia in children, however, the feasibility of such studies is an important barrier. Radiography, computed tomography and to a lesser extent ultrasonography and magnetic resonance imaging play an important role in complicated pneumonias but there are limitations that preclude their use as routine diagnostic tools. A standardised definition of alveolar pneumonia on a CXR exists for epidemiological studies targeting bacterial pneumonias but it should not be extrapolated to clinical settings. Chest radiographs (CXRs) are the most widely employed test, however, they are not indicated in ambulatory settings, cannot distinguish between viral and bacterial infections and have a limited role in the ongoing management of disease. Here we review the role of radiology in the diagnosis of paediatric pneumonia. The utility of clinical, microbiological and radiological diagnostic approaches varies widely within and between populations and is heavily dependent on the expertise and resources available in various settings. Despite the importance of paediatric pneumonia as a cause of short and long-term morbidity and mortality worldwide, a reliable gold standard for its diagnosis remains elusive.

Pcp pneumonia chest x ray findings