Abstract
The value of the lateral chest radiograph, often considered a useful adjunct in the detection of hilar adenopathy, was evaluated in a prospective study of 449 children assessed for tuberculosis. Of these children 298 presented to the hospital with signs and symptoms suggestive of tuberculosis, while 151 were investigated in a regional clinic solely because they were in close contact with an adult household member on treatment for tuberculosis. Tuberculosis was confirmed by culture in 176 of the 449 children (39%). In 40 of these (23%) hilar adenopathy was visible on frontal and lateral view, in 19 of the 176 confirmed cases (11%) only on a frontal view and in 22 (13%) on a lateral view only. Probable tuberculosis was diagnosed in a further 140 of the 449 children (31%), and hilar adenopathy was visible on frontal and lateral views in 39 of these children (28%), on the frontal view only in 8 (6%) and on the lateral view only in 27 (19%). In the symptomatic children investigated in the hospital, and the asymptomatic children investigated in the clinic, hilar adenopathy was detected on the lateral chest radiograph only in 36 (12%) and 14 (9%) cases respectively. Lateral chest radiographs will considerably improve the accuracy of the diagnosis of childhood tuberculosis.
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Jacobs M, Yach D, Fisher S, Kibel M, Hatting S, Coetzee G (1987) Management of children with tuberculosis in a local authority of Cape Town. S Afr J Epidemiol Infect 2: 15
Sham MK, Humphries MJ, Gabriel M (1989) Childhood respiratory tuberculosis in Hong Kong — a study of 301 children with respiratory tuberculosis treated at Ruttonjee Sanatorium. Hong Kong J Paediatr 6: 3
World Health Organisation (1983) Provisional guidelines for the diagnosis and classification of the EPI target diseases for primary health care. Surveillance and special studies., EPI/GEN/83/4
Donald PR, Ball J, Beyers JA (1985) Bacteriologically confirmed pulmonary tuberculosis in childhood. S Afr Med J 67: 588
Freiman I, Geefhuysen J, Solomon A (1975) The radiological presentation of pulmonary tuberculosis in children. S Afr Med J 49: 1703
Caffey J (1987) Pediatric X-ray diagnosis. Year Book, Chicago, p 469–470
Medical Officer Health, Western Cape Regional Services Council (1991) Annual report of the Department of Health Services 29: 245
Cundall DB (1986) The diagnosis of pulmonary tuberculosis in malnourished Kenyan children. Ann Trop Paediatr 6: 249
Stoltz AP, Donald PR, Strebel PM, Talent JMT (1990) Criteria for the notification of childhood tuberculosis in a high-incidence area of the Western Cape Province. S Afr Med J 77: 385
Lamont AC, Cremin BJ, Pelteret RM (1986) Radiological patterns of pulmonary tuberculosis in the paediatric age group. Paediatr Radiol 16: 2
Schaaf HS, Gie RP, Beyers N, Smuts N, Donald PR (1993) Tuberculosis in infants less than 3 months of age. Arch Dis Child 69: 371
Sagel SS, Evens RG, Forrest JV, Bramsen RT (1974) Efficacy of routine screening and lateral chest radiographs in a hospitalbased population. N Engl J Med 291: 1001
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Smuts, N.A., Beyers, N., Gie, R.P. et al. Value of the lateral chest radiograph in tuberculosis in children. Pediatr Radiol 24, 478–480 (1994). https://doi.org/10.1007/BF02015003
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DOI: https://doi.org/10.1007/BF02015003