Diagnostic Accuracy of Chest Ultrasonography versus Chest X-ray in Detecting Community-Acquired Pneumonia in Children: A Prospective Observational Study.

Authors

  • Dr. Navya K. U Consultant Pediatrician, Nagumagu Child Care Hospital, Hospet, Karnataka, India.
  • Dr. Manu Srinivas H Associate Professor, Department of Pediatric Radiology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India
  • Dr. Naveenkumar B Consultant Pediatrician, Motherhood Hospitals, Banashankari, Bengaluru, Karnataka, India.
  • Dr. Rashmi Devaraj Assistant Professor, Department of Neurology, Apollo Specialty Hospital, Bangalore, Karnataka, India
  • Dr. Rajashekar Murthy G. R Professor, Department of Pediatrics, Atal Bihari Vajpayee Medical College and Bowring and Lady Curzon Hospital, Bangalore,Karnataka, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i6.1865

Keywords:

Community-acquired pneumonia, chest ultrasonography, lung ultrasound, chest X-ray, children, diagnosis, radiation-free imaging

Abstract

Background:

Pneumonia remains a leading cause of childhood morbidity and mortality worldwide. Chest X-ray (CXR) is a conventional imaging modality for diagnosis, but it has limitations, including radiation exposure and variable interpretation. Lung ultrasonography (LUS) has emerged as a radiation-free, point-of-care diagnostic alternative. This study evaluated the diagnostic performance of LUS in detecting community-acquired pneumonia (CAP) in children and compared it with CXR.

 Objectives:

To assess the role of chest ultrasonography in diagnosing community-acquired pneumonia in children and to compare its diagnostic yield with that of chest X-ray.

 Methods:

A hospital-based prospective observational study was conducted from January to December 2019 at a tertiary pediatric center. Children aged 2 months to 5 years with clinical features of CAP were included in the study. Each child underwent CXR and LUS. Findings from both modalities were compared to assess their diagnostic accuracy.

 Results:

A total of 159 children were included, with a mean age of 16.9 ± 16.58 months. Chest ultrasound detected pneumonia in 134 (84.3%) cases, whereas CXR detected it in 113 (71%) cases (p < 0.0001). Subpleural consolidation (38.4%) and B-line with pleural line abnormalities (27%) were common LUS findings. CXR showed consolidation in 34.6% and perihilar infiltrates in 27.7% of cases. LUS detected pneumonia in 26 cases missed by CXR, while CXR detected pneumonia in 5 cases missed by LUS.

 Conclusion:

Lung ultrasonography is a simple, radiation-free, and reliable imaging modality with higher detection rates than chest X-ray in pediatric pneumonia. It can be used effectively for both diagnosis and follow-up, especially in resource-limited settings.

 Recommendations:

Lung ultrasound should be integrated into pediatric emergency protocols as a first-line imaging tool for suspected pneumonia in children.

Author Biographies

Dr. Navya K. U, Consultant Pediatrician, Nagumagu Child Care Hospital, Hospet, Karnataka, India.

Dr. Navya K. U is currently working as a Consultant Pediatrician at Nagumagu Child Care Hospital, Hospet, Karnataka, India. She completed her MBBS from Shivamogga Institute of Medical Sciences, Shivamogga, and obtained her MD in Pediatrics from the esteemed Indira Gandhi Institute of Child Health, Bangalore. She also holds a Diplomate of National Board (DNB) degree in Pediatrics. Dr. Navya has served as a Senior Resident at the prestigious Bangalore Medical College for one year. She subsequently worked as a Pediatric Registrar and DNB teaching faculty at Sagar Hospitals, Bangalore, for two years. With extensive clinical experience in neonatal and pediatric intensive care (NICU and PICU), she is well-versed in managing critically ill children and handling complex tertiary care pediatric cases.ORCID iD: http://orcid.org/0009-0007-9267-2515

Dr. Manu Srinivas H, Associate Professor, Department of Pediatric Radiology, Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India

Dr. Manu Srinivas H is an Associate Professor in the Department of Pediatric Radiology at Indira Gandhi Institute of Child Health, Bangalore, Karnataka, India. He completed his MBBS from M.S. Ramaiah Medical College, Bangalore, and earned his MD in Radiology from Meenakshi Medical College, Kancheepuram. With over 12 years of teaching experience, Dr. Manu has mentored numerous post-MD fellows in Pediatric Radiology and has contributed to the field through publications in reputed journals. He currently serves as the Head of the Department of Pediatric Radiology, providing diagnostic and interventional radiology support across various pediatric subspecialties.ORCID iD: http://orcid.org/0009-0006-7660-3256

Dr. Naveenkumar B, Consultant Pediatrician, Motherhood Hospitals, Banashankari, Bengaluru, Karnataka, India.

Dr. Naveenkumar B. is currently serving as a Consultant Pediatrician at Motherhood Hospitals, Banashankari, Bengaluru, Karnataka, India. He completed his MBBS from Mysore Medical College and earned his MD in Pediatrics from the prestigious Indira Gandhi Institute of Child Health, Bangalore. In addition, he holds a DNB in Pediatrics. Naveenkumar has previously worked as a Senior Resident at Bangalore Medical College and served as a Pediatric Consultant at Sanyra Hospital, Bengaluru, for one year. He has also worked as a PICU Consultant at KCG Hospital, Bangalore. With extensive clinical experience in managing critically ill neonates and children, he specializes in neonatal and pediatric intensive care (NICU and PICU).ORCID iD: http://orcid.org/0009-0007-5398-8314

Dr. Rashmi Devaraj, Assistant Professor, Department of Neurology, Apollo Specialty Hospital, Bangalore, Karnataka, India

Dr. Rashmi Devaraj is currently working as an Assistant Professor in the Department of Neurology at Apollo Specialty Hospital, Bangalore. She completed her MBBS and MD in Pediatrics from Bangalore Medical College and Research Institute (BMCRI), followed by a DM in Neurology from the prestigious NIMHANS. With over 7 years of teaching experience, Dr. Rashmi has authored 10 research papers published in national and international journals. She has been actively involved in research, including an ICMR-funded project during her DM training. A recipient of multiple gold medals and quiz competition awards, she continues to contribute significantly to the field of pediatric and adult neurology.ORCID iD: https://orcid.org/0000-0001-8280-0690

Dr. Rajashekar Murthy G. R, Professor, Department of Pediatrics, Atal Bihari Vajpayee Medical College and Bowring and Lady Curzon Hospital, Bangalore,Karnataka, India

Dr. Rajashekar Murthy G. R. is a distinguished pediatrician with over 30 years of academic and clinical experience. He served as Professor of Pediatrics at Indira Gandhi Institute of Child Health, Bangalore, and is currently associated with Atal Bihari Vajpayee Medical College and Bowring and Lady Curzon Hospital, Bangalore, as well as the Bowring Institute, Bangalore. He completed his MBBS from Davangere Medical College and obtained his DCH and MD in Pediatrics from the prestigious Bangalore Medical College, Karnataka. Throughout his illustrious career, Dr. Rajashekar has guided numerous postgraduate and undergraduate students in their research and academic projects in the field of pediatrics and neonatology. He has published 19 research articles in national and international journals and has been a postgraduate teacher and examiner for the National Board of Examinations, New Delhi, for over 15 years. Additionally, he has served as an examiner and evaluator for various health universities across India for the past 19 years.ORCID iD: https://orcid.org/0009-0009-1788-5494

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Published

2025-06-30

How to Cite

Dr. Navya K. U, Srinivas H, D. M. ., Kumar B, N. ., Devaraj, D. R. ., & Murthy G. R, R. . (2025). Diagnostic Accuracy of Chest Ultrasonography versus Chest X-ray in Detecting Community-Acquired Pneumonia in Children: A Prospective Observational Study. Student’s Journal of Health Research Africa, 6(6), 10. https://doi.org/10.51168/sjhrafrica.v6i6.1865

Issue

Vol. 6 No. 6 (2025): June 2025 Issue

Section

Section of Pediatrics and Child Health

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Copyright (c) 2025 Dr. Navya K. U, Dr. Manu Srinivas H, Dr. Naveenkumar B, Dr. Rashmi Devaraj, Dr. Rajashekar Murthy G. R

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