Lung Ultrasound Findings Undetectable by Chest Radiography in Children with Community-Acquired Pneumonia

The purpose of our study was to evaluate any differences between lung ultrasonography and chest radiography (CR) images in children with a diagnosis of community-acquired pneumonia (CAP) and, if there are any, to analyze the reasons and possible clinical implications. We reviewed the medical records of patients admitted to the pediatric ward from January 2014 to December 2016 and selected only cases discharged with a diagnosis of CAP who had undergone performed lung ultrasound (LUS) and CR within 24 h of each other. All radiologic and sonographic images of the selected cases were examined blindly by a senior radiologist and a skilled sonographer, respectively, with respect to number, position and size of lung injuries. Of the 47 cases of pneumonia, 28 lung lesions spotted by LUS were undetected by CR. Compared with CR, LUS detects more cases of pneumonia, a greater number of cases of double pneumonia and minimal pleural effusions. LUS should be considered the first-line imaging tool for CAP.