The lateral decubitus view: an aid in evaluating poorly defined pulmonary densities in children

The upper lung on a lateral decubitus chest radiograph is uniformly better expanded than on a frontal upright chest radiograph. The lateral decubitus view is useful in distinguishing pulmonary vascular structures mimicking pneumonia from actual pulmonary infiltrates in infants and young children in whom deep inspiratory chest films are difficult to obtain. This study included 20 children whose initial radiographs could not be obtained in deep inspiration and demonstrated equivocal areas of pulmonary infiltrate. Clinical follow-up was possible in 16 of the 20 patients. We reviewed the routine chest radiographs and lateral decubitus views independently and retrospectively. The decubitus films showed more appropriate correlation with the subsequent clinical course and consistently allowed more confident interpretation of the radiographs.