Roentgenographic Abnormalities in Children Hospitalized for Asthma Deliberation

The total incidence of roentgenographic abnormalities (64.1 percent) in our series of children who were hospitalized for status asthmaticus is similar to previously reported observations. The most common abnormality was hyperinflation, found in 35.9 percent of those studied roentgenographically. Of the 35 patients (27.3 percent) with opacifications on their chest x-ray film, only six (4.7 percent) were suggestive of pneumonia. This is comparable to the data of Eggleston et al who reported pneumonitis in 4.5 percent of his asthmatic patients. His group found both pneumomediastinum and pulmonary infiltrates to be strikingly age-dependent This was not true in our series. Peribronchial thickening has been reported to occur in 27-64 percent of patients with asthma. Since this common finding was equally distributed among all groups and had no effect on management of the acute asthmatic attack, we elected not to consider it a significant abnormality for the purposes of this study.
Child with AsthmaAll groups in our study exhibited an elevated temperature, but this was probably secondary to the respiratory illness which frequently precipitated the asthma attacks. Find the detailed information about asthma on our site –

Our prospective data corroborate the findings of Gillies et al who were unable to demonstrate a correlation between radiographic findings and clinical assessments obtained retrospectively through chart review. In our study, neither clinical score, vital signs, nor duration of the attack were predictors of roentgenographic abnormalities.

The physicians’ subjective assessment, based primarily on auscultatory findings, was no more accurate than other parameters in predicting abnormalities. Their assessment predicted only three of seven significant abnormalities with 14 false positives. Chest roentgenograms may, however, be the only way to detect certain abnormalities in patients with asthma and therefore should be obtained in any children who appear particularly ill, who do not respond to therapy as quickly as expected, or who, for any reason, indicate that some process other than uncomplicated asthma is involved. Any recommendation must be tempered by the low yield and lack of influence of positive findings on patient management, as well as the radiation and expense involved.

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