Mimics of Acute Pneumonia in Children and Adolescents: A Pictorial Review of Radiological Appearances

Respiratory symptoms commonly present in children and adolescents and, in most cases, are due to infection. Radiological imaging is generally reserved for cases in which there is sufficient diagnostic uncertainty or illness severity so as to justify the associated exposure to ionising radiation. Plain film radiography is the first line imaging modality, however computed tomography (CT), when performed in carefully selected cases, can more accurately evaluate thoracic anatomy and pathology and, in doing so, may reveal an alternative, sometimes unexpected, diagnosis.

This review serves to explore the variety of thoracic pathology that may precipitate presentation with respiratory symptoms in children and adolescents and, in doing so, to emphasise the importance of the differential diagnosis in children with an atypical presentation or disease course. In addition, it highlights the role of radiological imaging in carefully selected children, for whom detailed evaluation of thoracic anatomy and pathology can inform appropriate management and improve outcome.