Should Infants with Bronchiolitis Have Chest X-Rays?

Acute bronchiolitis, characterized by tachypnea, cough, and wheezing, is generally viral. Recommendations for chest radiography vary: Some sources recommend it routinely; others, only in limited situations. Investigators at a Toronto pediatric hospital recently examined how routine chest radiography influences treatment decisions.

The researchers enrolled 265 infants 2 to 23 months of age who came to the emergency department (ED) with typical presentations of acute bronchiolitis. All were treated with two or three nebulizations of albuterol before undergoing chest radiography. ED physicians were asked both before and after viewing the radiographs whether hospital admission or antibiotic treatment was planned. Radiographs were interpreted as …