Chest Tuberculosis in Children

  • Priyanka Naranje
  • Ashu Seith BhallaEmail author
  • Poonam Sherwani
Review Article


Chest is the commonest site of involvement by tuberculosis (TB) in children; lungs being the most frequently affected region, followed by nodes, pleura and chest wall. It is difficult to diagnose TB in children due to lack of overt symptoms and difficulty in obtaining samples for microbiological confirmation. Hence various imaging modalities play an important role in diagnostic algorithm as well as in follow-up after treatment. Standardization of chest radiograph reporting in context of clinically suspected TB is the need of the hour so as to suggest a proper diagnosis and avoid over-diagnosis. This article aims to discuss the imaging features of chest tuberculosis according to the site of involvement on various imaging modalities in the pediatric population.


Chest tuberculosis Children Imaging Recommendations CT Ultrasound MRI 


Author’s Contribution

PN: Manuscript preparation, figures & cases and literature search; ASB: Conception and design of the work, drafting the article, critical revision of the article; PS: Literature search, writing the initial draft and figures. The final manuscript was checked and approved by all the authors.ASB will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding



  1. 1.
    Abel L, El-Baghdadi J, Bousfiha AA, Casanova JL, Schurr E. Human genetics of tuberculosis: a long and winding road. Philos Trans R Soc Lond Ser B Biol Sci. 2014;369:20130428.CrossRefGoogle Scholar
  2. 2.
    Swingler GH, du Toit G, Andronikou S, van der Merwe L, Zar HJ. Diagnostic accuracy of chest radiography in detecting mediastinal lymphadenopathy in suspected pulmonary tuberculosis. Arch Dis Child. 2005;90:1153–6.CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Du Toit G, Swingler G, Iloni K. Observer variation in detecting lymphadenopathy on chest radiography. Int J Tuberc Lung Dis. 2002;6:814–7.Google Scholar
  4. 4.
    Kumar A, Gupta D, Nagaraja SB, et al. Updated national guidelines for pediatric tuberculosis in India, 2012. Indian Pediatr. 2013;50:301–6.Google Scholar
  5. 5.
    Graham SM, Ahmed T, Amanullah F, et al. Evaluation of tuberculosis diagnostics in children: 1. Proposed clinical case definitions for classification of intrathoracic tuberculosis disease. Consensus from an expert panel. J Infect Dis. 2012;205:S199–208.Google Scholar
  6. 6.
    Bhalla AS, Goyal A, Guleria R, Gupta AK. Chest tuberculosis: Radiological review and imaging recommendations. Indian J Radiol Imaging. 2015;25:213–25.Google Scholar
  7. 7.
    Concepcion NDP, Laya BF, Andronikou S, et al. Standardized radiographic interpretation of thoracic tuberculosis in children. Pediatr Radiol. 2017;47:1237–48.Google Scholar
  8. 8.
    Sodhi KS, Bhalla AS, Mahomed N, Laya BF. Imaging of thoracic tuberculosis in children: current and future directions. Pediatr Radiol. 2017;47:1260–8.CrossRefGoogle Scholar
  9. 9.
    Bosch-Marcet J, Serres-Créixams X, Zuasnabar-Cotro A, Codina-Puig X, Català-Puigbó M, Simon-Riazuelo JL. Comparison of ultrasound with plain radiography and CT for the detection of mediastinal lymphadenopathy in children with tuberculosis. Pediatr Radiol. 2004;34:895–900.CrossRefGoogle Scholar
  10. 10.
    Lew WJ, Jung YJ, Song JW, et al. Combined use of QuantiFERON-TB gold assay and chest computed tomography in a tuberculosis outbreak. Int J Tuberc Lung Dis. 2009;13:633–9.Google Scholar
  11. 11.
    Veedu PT, Bhalla AS, Vishnubhatla S, et al. Pediatric vs adult pulmonary tuberculosis: a retrospective computed tomography study. World J Clin Pediatr. 2013;2:70–6.Google Scholar
  12. 12.
    Mukund A, Khurana R, Bhalla AS, Gupta AK, Kabra SK. CT patterns of nodal disease in pediatric chest tuberculosis. World J Radiol. 2011;3:17–23.Google Scholar
  13. 13.
    Kaur R, Jana M. Imaging in chest tuberculosis. In: Bhalla AS, Jana M, editors. Clinico-Radiological Series: Imaging of Chest Infections, 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2018. p. 124–45.Google Scholar
  14. 14.
    Moyes EN. Tuberculoma of the lung. Thorax. 1951;6:238–49.CrossRefPubMedCentralGoogle Scholar
  15. 15.
    Naranje P, Guleria R. Imaging of infections of pleura and chest wall. In: Bhalla AS, Jana M, editors. Clinico Radiological Series: Imaging of Chest Infections, 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2018. p. 385–403.Google Scholar
  16. 16.
    Arora A, Bhalla AS, Jana M, Sharma R. Overview of airway involvement in tuberculosis. J Med Imaging Radiat Oncol. 2013;57:576–81.CrossRefGoogle Scholar
  17. 17.
    Rizzi EB, Schinina' V, Cristofaro M, et al. Detection of pulmonary tuberculosis: comparing MR imaging with HRCT. BMC Infect Dis. 2011;11:243.CrossRefGoogle Scholar
  18. 18.
    Manson DE. MR imaging of the chest in children. Acta Radiol. 2013;54:1075–85.CrossRefGoogle Scholar
  19. 19.
    Baez JC, Ciet P, Mulkern R, Seethamraju RT, Lee EY. Pediatric chest MR imaging: lung and airways. Magn Reson Imaging Clin N Am. 2015;23:337–49.CrossRefGoogle Scholar
  20. 20.
    Sodhi KS, Khandelwal N, Saxena AK, et al. Rapid lung MRI in children with pulmonary infections: time to change our diagnostic algorithms. J Magn Reson Imaging. 2016;43:1196–206.Google Scholar
  21. 21.
    Vorster M, Sathekge MM, Bomanji J. Advances in imaging of tuberculosis: the role of 18F-FDG PET and PET/CT. Curr Opin Pulm Med. 2014;20:287–93.CrossRefGoogle Scholar
  22. 22.
    Pelletier-Galarneau M, Martineau P, Zuckier LS, Pham X, Lambert R, Turpin S. 18F-FDG-PET/CT imaging of thoracic and extrathoracic tuberculosis in children. Semin Nucl Med. 2017;47:304–18.CrossRefGoogle Scholar
  23. 23.
    Willowson KP, Bailey EA, Bailey DL. A retrospective evaluation of radiation dose associated with low dose FDG protocols in whole-body PET/CT. Australas Phys Eng Sci Med. 2012;35:49–53.CrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  • Priyanka Naranje
    • 1
  • Ashu Seith Bhalla
    • 1
    Email author
  • Poonam Sherwani
    • 1
  1. 1.Department of RadiodiagnosisAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations