Ultrasound more accurate than stethoscope for diagnosing pneumonia in kids

Point-of-care-ultrasound is more accurate than the traditional method of using a stethoscope in diagnosing pneumonia in children and young adults, according to a study published online Dec. 10 in the Archives of Pediatrics and Adolescent Medicine.

The researchers studied 200 patients ranging from infants to 21-year-old young adults who presented with a possible diagnosis of pneumonia to Bellevue Hospital Center in New York between 2008 and 2010. They found that point-of-care ultrasound had a specificity of 97 percent for diagnosing pneumonia, with sensitivity as high as 92 percent.

Accuracy for diagnosis with a stethoscope was lower--with specificity of between 77 and 83 percent and 24 percent sensitivity.

"The World Health Organization has estimated as many as three-quarters of the world's population, especially in the developing world, does not have access to any diagnostic imaging, such as chest X-ray, to detect pneumonia," senior author James Tsung, an associate professor of emergency medicine and pediatrics at Mount Sinai School of Medicine in New York, said according to an announcement. "Many children treated with antibiotics may only have a viral infection--not pneumonia. Portable ultrasound machines can provide a more accurate diagnosis of pneumonia than a stethoscope."

The researchers also found that ultrasound was able to detect pneumonia that was too small (less than 1 centimeter) for X-ray to detect in 12 of 48 cases with a confirmed diagnosis of pneumonia.

In an accompanying editorial, Kassa Darge, M.D., and Aaron Chen, M.D., said that further studies are needed to confirm these results, but that in the future, ultrasound may need to complement--if not replace--chest X-ray to diagnose pneumonia in children.

To learn more:
- see study abstract
- see the announcement
- read the editorial

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