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Abstract

There are no widely accepted predictors of pneumonia in wheezing infants and toddlers who present to the emergency department (ED). A 10-month retrospective review of ED visits of wheezing children ≤18 months of age revealed the following chest radiograph (CXR) results: normal (21 %), findings consistent with uncomplicated bronchiolitis or asthma (61%), focal infiltrates (18%), and other abnormalities (<1%). Patients with focal infiltrates on CXR were more likely to have the following: a history of fever (p=0.03, OR 2.1, 95% CI 1.0, 4.4), temperature ≥38.4° (p=0.01, OR 2.5, 95% CI 1.1,5.8) or crackles on examination (p<0.0005, OR 3.9, 95% CI 1.7,9.0). Selective use of CXRs has the potential to save health care dollars and limit unnecessary radiation. Clin Pediatr. 1999;38:395-399

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References

Oski FA Recurrent or persistent lower respiratory tract symptoms. In: DeAngelis CD , Feigin RD , McMillan JA , et al, eds. Principles and Practices of Pediatrics. Philadelphia: JB Lippincott Company; 1994:1519-1520.

Simpson W. , Hacking PM , Court Sdm , et al. The radiological findings in respiratory syncytial virus infection in children. Pediatr Radiol. 1974;2:155-159.

Gershel JC , Goldman HS , Stein Rek , et al. The usefulness of chest radiographs in first asthma attacks . N Engl J Med. 1983;309:336-339.

Dawson KP , Long A. , Kennedy J. , et al. The chest radiograph in acute bronchiolitis. J Pediatr Child Health. 1990;26:209-211.

Eriksson J. , Nordshus T. , Carlsen KH , et al. Radiological findings in children with respiratory syncytial virus infection: relationship to clinical and bacteriological findings. Pediatr Radiol. 1986;16:120-122.

Gardner PS How etiologic, pathologic, and clinical diagnoses can be made in a correlated fashion. Pediatr Res. 1977;11:254-261.

Dawson K. , Penna A. Observations on the management of childhood acute asthma in a large hospital . Med J Aust. 1992;156:845-846.

Bramson R. , Meyer T. , Silbiger M. , et al. The futility of the chest radiograph in the febrile infant without respiratory symptoms. Pediatrics. 1993;92:524-526.

Losek J. , Kishaba RG , Berens R. , et al. Indications for chest roentgenogram in the febrile young infant . Pediatr Emerg Care. 1989;5:149-152.

10.

Crain E. , Bulas D. , Bijur P. , et al. Is a chest radiograph necessary in the evaluation of every febrile infant less than 8 weeks of age? Pediatrics. 1991;88:821-824.

11.

Heulitt M. , Ablow R. , Santos C. , et al. Febrile infants less than 3 months old: value of chest radiography , Radiology. 1988;167:135-137.

12.

Leventhal JM Clinical predictors of pneumonia as a guide to ordering chest roentgenograms. Clin Pediatr. 1982;21:730-734.

13.

Zukin D. , Hoffman J. , Cleveland R. , et al. Correlation of pulmonary signs and symptoms with chest radiographs in the pediatric age group. Ann Emerg Med. 1986;15:792-796.

14.

Rushton AR The role of the chest radiograph in the management of childhood asthma . Clin Pediatr. 1982; 21:325-328.

15.

Friis B. , Eiken M. , Hornsleth A. , et al. Chest x-ray appearances in pneumonia and bronchiolitis: correlation to virological diagnosis and secretory bacterial findings. Acta Paediatr Scand. 1990;79:219-225.

16.

Eggleston P. , Ward B. , Pierson W. , et al. Radiographic abnormalities in acute asthma in children. Pediatrics. 1974 ; 54:442-449.

17.

Babcook CJ , Norman GR , Coblentz CL Effect of clinical history on the interpretation of chest radiographs in childhood bronchiolitis. Invest Radiol. 1993;28:214-217.

18.

Fosarelli P. , DeAngelis C. Outpatient radiographic exposure in the first five years of life. Clin Pediatr. 1987 ;26:296-301.

Chest Radiographs in the Pediatric Emergency Department for Children ≤18 Months of Age with Wheezing

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