What is the value of a chest radiograph in evaluation of a child with suspected respiratory failure?
In previously healthy children, respiratory failure is generally preceded by clinically identifiable respiratory distress. Young children with fever and tachypnea may benefit from a chest radiograph, because bacterial pneumonia can be difficult to diagnose by history and physical examination alone. Foreign-body aspiration, pneumothorax/pneumomediastinum, and cardiac disease are a few of the diagnoses that can also be suspected on the basis of a chest radiograph. Children with minor respiratory illnesses generally do not need chest radiographs, even if they seek care in an ED. If there is concern about impending or existing respiratory failure, a chest radiograph can be very useful.