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Ultrasound best for diagnosing pneumonia

A study that compared traditional auscultation by stethoscope with ultrasonography for diagnosing pneumonia in children and young adults has found that ultrasound is more accurate.

Researchers looked at 200 patients aged between birth and 21 years (median age, 3 years) who were given chest x-rays for suspected community-acquired pneumonia at the emergency departments of 2 urban hospitals. After clinical diagnosis of pneumonia, patients underwent ultrasonography.

Chest radiography confirmed prevalence of pneumonia among 18% of patients. Ultrasound showed high specificity (97%) and sensitivity (86%) for diagnosing pneumonia lung consolidation. In contrast, specificity for auscultation by stethoscope was 77% to 83%, with 24% sensitivity. Ultrasound also detected pneumonias as small as 1 cm or less, which a chest x-ray might miss.

The researchers say that diagnosing pneumonia by stethoscope can be difficult when the patient is coughing or wheezing, whereas ultrasound is not affected.

Shah VP, Tunik MG, Tsung JW. Prospective evaluation of point-of-care ultrasonography for the diagnosis of pneumonia in children and young adults. Arch Pediatr Adolesc Med. 2012. Epub ahead of print.