Point-of-Care Ultrasound Differentiation of Lung Consolidation and Normal Thymus in Pediatric Patients: An Educational Case Series.

BACKGROUND: There is a growing body of evidence to support the utility of lung point-of-care ultrasound (POCUS) in pediatric patients with multiple pulmonary pathologies, particularly pneumonia. As we increase our use of lung POCUS for pediatric patients with respiratory complaints, we must be mindful of the normal anatomy and sonographic findings within the pediatric chest and aware of how to distinguish normal findings (e.g., thymus) from pathologic findings (e.g., consolidation).

CASE REPORTS: We report four cases of pediatric patients who presented to the Emergency Department with respiratory complaints for which POCUS was able to distinguish lung consolidation and normal thymus in the anterior chest. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The use of lung ultrasound to detect pneumonia is extensively documented in the pediatric literature. Emergency physicians may not be aware of how to discriminate the normal sonographic appearance of the thymus from lung consolidation on POCUS. The ability to identify normal and pathologic findings within the pediatric chest by POCUS will be increasingly important to appropriately reduce the use of plain radiography for pediatric patients with respiratory complaints.