Evaluation of chest x-rays in children with acute wheezing

Abstract

This paper was designed as a review of different CXR presentations in our asthmatic patients, or children with wheezing caused by other pathological conditions. Wheezing and asthma are common in childhood. Wheezing is just one of the symptoms of asthma, but also may be a sign associated with a number of various and sometimes very serious diseases. All pediatricians should bear in mind that “not all that wheezes is asthma”. It is estimated that approximately 30% of children have episodes of wheezing or asthma at some stage. Physicians frequently order chest X-rays (CXR) for suspected asthmatic children or severe asthmatic children in acute attacks, in children with wheezing who are less than 5 years of age, for those with a temperature greater than 38.30C, those with symptoms for longer than few days, or tachypnea and dyspnea. Retrospective reviews of CXR in children with asthma and wheezing disorders suggest than in most circumstances this investigation does not contribute to diagnosis and management. However, CXR may be of use in identifying complications of asthma or recognizing other wheezing disorders. Unrecognized causes of wheezing may cause serious complications and even fatal outcome.

Conclusion – An efficient approach in patients with wheezing would be to forego CXR when a clinical diagnosis is certain, and to perform them only if a complication is suspected or if the etiology of the respiratory illness is uncertain.