Can chest x-ray predict pneumonia severity and its outcome in children aged 2 months - 5 years?

Background: Worldwide 16% of death in children under the age 5 years is only due to pneumonia every year. Among the diagnostic modality x-ray chest is simple tool to diagnose the pneumonia especially in developing country like in India. Aims of study was to know the incidence of radiologically proven pneumonia and to see the correlation between x-rays findings and clinical severity of pneumonia, so as to predict the severity of pneumonia on the basis of x-ray chest done on first day of hospitalization.Methods: We did the study in department of pediatrics at tertiary care centre, total 150 patients of pneumonia (2 months to 5 years age) enrolled on clinical basis. X-ray chest done in all patients on first contact.Results: Out of 150 patients, 54% of patient having radiologically proven pneumonia while 46% were normal x-ray findings. We found that interstitial pneumonia were more common in younger children, but lobar pneumonia were more common in older children, but in severe and very severe pneumonia cases most common radiologically proven pneumonia were bronchopneumonia in all age group, which was statistically significant.Conclusions: So the basis of start of treatment should be on the clinical background and clinical severity, not only on the basis of x-ray chest findings. Late x-ray films give more chance of positive findings, multilobar infiltration or diffuse heterogeneous opacity in lungs positively correlated with clinical severity and gives idea about course and duration of hospitalization.