Pediatric lung ultrasound cons – are they really strong enough?

Excerpt

In his article “Lung ultrasound in pediatric radiology – cons” [1], Paolo Tomà has excellently gone through the publishing history of articles dealing with thoracic ultrasound (US) from 1975 to the present. An increasing number of publications, especially from the mid-1990s to now, demonstrate the increasing interest in this diagnostic tool. There is an old proverb in my country saying “a huge cloud of dust always follows a good horse.” When there is so much recent talk about lung US, there has to be something worthy about it. However, there is something intriguing and incomplete about it, too, otherwise its impact on everyday clinical practice would not be persistently questioned. I have a feeling that we are circling around the same story over and over again. It is obvious that lung US is not a perfect, self-sufficient diagnostic tool. It is not possible to assess central airways, hilar and subscapular regions and to detect any pathological entity that does not abut the pleura. Lines, tubes and some air leak phenomena are also problematic, as Tomà emphasizes. Yet lung US exists with all its imperfections, and numerous studies report its strong impact on everyday clinical work, with high sensitivity and specificity [2, 3], which cannot be explained as a coincidence. The applications of lung US most frequently studied are pediatric pneumonia and neonatal lung disease and their complications. …