The clinical impact of the radiology report in wheezing and nonwheezing febrile children: a survey of clinicians

Pediatr Radiol. 2009 Apr;39(4):348-53. doi: 10.1007/s00247-009-1154-4. Epub 2009 Feb 25.


Background: The chest radiograph is commonly used in the diagnosis and management of patients presenting with respiratory illness. The language used to describe the findings is important to ensure appropriate communication with the referring clinician and thereby optimize patient management.

Objective: In this study we attempted to determine how clinicians interpret specific terms commonly used in a chest radiograph report, and to assess how these terms impact the management of children with respiratory symptoms.

Materials and methods: An online survey was distributed to 562 pediatric practitioners asking their interpretation of the terms "peripheral airway disease (PAD)," "focal airspace consolidation," and "focal infiltrate" in a febrile child with or without wheezing.

Results: There were 112 respondents. Most practitioners defined the term "PAD" as viral pneumonia (61.5%) or asthma (56.9%), "consolidation" as atelectasis (83%) followed by pneumonia (69.6%), and "infiltrate" as pneumonia (100%), followed by atelectasis (22.3%). Practitioners were more likely to treat a nonwheezing child with antibiotics if the report stated "focal airspace consolidation" (80%) or "focal infiltrate" (100%; P=0.001).

Conclusion: Some radiologic descriptors may lead to diverse and sometimes unintended diagnostic conclusions. Our findings support continued effort to structure and standardize the radiology report and our descriptive terminology.

MeSH terms

  • Documentation / statistics & numerical data*
  • Fever of Unknown Origin / classification*
  • Fever of Unknown Origin / diagnosis*
  • Humans
  • Physicians / statistics & numerical data*
  • Professional Competence
  • Radiography, Thoracic / statistics & numerical data
  • Respiration Disorders / classification*
  • Respiration Disorders / diagnostic imaging*
  • Respiratory Sounds / classification*
  • Surveys and Questionnaires
  • Tennessee
  • Terminology as Topic*