Does chest x-ray accurately diagnose croup?

The article is professionally consulted by Master, Doctor Luu Thi Bich Ngoc - Radiologist - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International Hospital

laryngotracheobronchitis is an acute respiratory infection common in children 6 - 36 months of age, mainly caused by influenza virus (type 1). The diagnosis of croup is usually based on physical examination, but chest and neck x-rays can show subglottic narrowing, which is an effective aid in diagnosing and excluding some similar conditions. on one's own.

Croup is a common respiratory infection in children 6 months to 3 years old. When infected, the patient's larynx and trachea will be irritated and swollen, causing difficulty breathing, stridor, hoarseness... In children, the disease can cause respiratory obstruction causing children to have a severe dry cough. . However, croup remains a benign disease with a low mortality rate. The incidence is highest during the rainy season or cold weather.

The disease is caused by many viruses such as respiratory syncytial virus RSV, Adenovirus, influenza A and B viruses, Rhinovirus, measles virus... but the most common is the parainfluenza virus (accounting for 50-75%). Patients are infected through airborne transmission or by contact with viral secretions. In addition, there are many other causes due to bacteria (diphtheria and Mycoplasma pneumoniae) or allergies.
Allergic factors may increase recurrence, especially when younger patients are more sensitive to viral antigens. In addition, gastroesophageal reflux is also a problem that needs to be controlled to reduce future episodes of croup.

To diagnose croup, your doctor will rely on your medical history, clinical symptoms, and a physical exam.
3.1. Clinical symptoms Patients often experience episodes of croup with symptoms such as:
Mild symptoms: mild fever, runny nose, difficulty swallowing, dry cough and hoarseness, voiceless crying, wheezing wheezing has signs of worsening at night. Severe symptoms: bulging nostrils, concave chest, wheezing (Respiratory failure). Most episodes of croup are mild and will improve on their own once the patient's cough stops. The severity of the disease also depends on the immune system as well as the structure of the airways of each person. The illness usually lasts about 3-7 days but can also last up to 2 weeks. For children, less than 10% of them need to be hospitalized for treatment.

3.2. Advantages of chest x-ray X-ray is a subclinical test that plays an important role in diagnosing lung diseases. The chest x-ray film shows the basic lesions in the lungs, the relationship with the surrounding organs such as ribs, mediastinum, trachea, diaphragm... The careful analysis of this correlation This will avoid confusion in the diagnosis of croup with other conditions such as epiglottitis, airway foreign body, bacterial bronchitis, diphtheria, and posterior pharyngeal abscess.
Although chest x-ray is not diagnostic for constriction, lung abnormalities can be ruled out in patients with wheezing or coughing.
If the diagnosis is not clear, the patient should be ordered to have a straight neck and chest x-ray (AP) and a tilt:
X-ray of the neck straight: shows narrowing of the subglottis (church bell sign) ) on a straight neck x-ray will assist in the diagnosis of croup. In critically ill patients, epiglottitis should be examined in the operating room by appropriate specialists for airway control, SpO2 measurement, and arterial blood gases in cases of respiratory failure. Tilt x-ray: clarifies mass-like lesions not clearly defined on straight film. Purpose of mediastinal zoning, locating lesions to lobes and lobes of lung. Patients who suspect a lesion on which side will perform a lateral scan on that side.

In general, the diagnosis of croup is usually quite obvious clinically, so imaging tests are not so necessary. However, for cases where symptoms are atypical or too severe, this method can still be applied to rule out other diseases.
laryngotracheobronchitis is a very common disease in children, so parents need to be very careful and when they notice that their child has the initial signs of onset, they need to take the child to a medical facility to be checked. and timely interventions.
Currently, the Pediatrics Department - Vinmec International General Hospital is full of leading experts, with high professional qualifications (professor, associate professor, doctorate, master), experienced, each Working at major hospitals across the country will directly participate in the process of examining and treating patients.
As a key field of the hospital, the Department of Pediatrics also provides a chain of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health. From birth to adulthood
Therefore, when a child has any health problems, parents can take the child to Vinmec hospital to be examined and experience the best services.