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The lateral radiograph of neck in laryngo-tracheo-bronchitis (croup)

K P Dawson1, A Steinberg, N Capaldi

  • 1Paediatric Department, Westmead Hospital, NSW, Australia.

Journal of Quality in Clinical Practice
|March 1, 1994
PubMed

Insights

Lateral neck X-rays for acute laryngo-tracheo-bronchitis (croup) in children are often unnecessary. This study found that these X-rays rarely influenced patient management, suggesting inefficient diagnostic practices.

Area of Science:

  • Pediatric Radiology
  • Pediatric Pulmonology
  • Diagnostic Imaging

Background:

  • Acute laryngo-tracheo-bronchitis (croup) is a common childhood respiratory illness.
  • Lateral neck X-rays are frequently used in the diagnostic workup of croup.
  • The clinical utility and impact of these imaging studies on patient management remain debated.

Purpose of the Study:

  • To evaluate the diagnostic accuracy and clinical relevance of lateral neck X-rays in children with suspected acute laryngo-tracheo-bronchitis.
  • To assess the influence of X-ray findings on the management decisions for these pediatric patients.

Main Methods:

  • Retrospective review of lateral neck radiographs from 61 children diagnosed with acute laryngo-tracheo-bronchitis.
  • Independent review of radiographs by a pediatric radiologist blinded to clinical history and outcomes.
  • Independent review of clinical records to determine the impact of X-ray findings on management.

Main Results:

  • Sixty percent of lateral neck X-rays were interpreted as consistent with acute laryngo-tracheo-bronchitis.
  • X-ray results had minimal impact on clinical management, except for one case where it influenced the decision for laryngoscopy.
  • No children experienced acute airway obstruction during their radiology examinations.

Conclusions:

  • Lateral neck X-rays in the context of suspected croup are frequently not clinically relevant.
  • The routine use of lateral neck X-rays for diagnosing croup represents an inefficient utilization of diagnostic resources.
  • Clinical assessment remains paramount in managing pediatric patients with suspected acute laryngo-tracheo-bronchitis.

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