Objective: In this study, it was aimed to evaluate the effectiveness of chest radiography in the diagnosis of COVID-19 pneumonia in pediatric patients.

Materials and Methods: Between 2020 and 2021, radiological images of pediatric patients with diagnosed COVID-19 by polymerase chain reaction test were evaluated retrospectively. A total of 140 patients who underwent both lung X-ray and thorax computed tomography (CT) were included in the study. The effectiveness of chest radiography in the diagnosis of COVID-19 pneumonia was determined. Thoracic CT scans were compared in cases without pneumonia findings on chest X-rays.

Results: Covid-19 pneumonia was detected in 100 of 140 thorax CT. Increased opacity was observed in the chest X-ray of 48 of these 100 patients (48%). Radiographs of the other 52 patients were normal. The reasons for this were low-density opacities (n=26 patients, 50%), small-sized opacities (n=16 patients, 30.7%), opacities adjacent to the diaphragm and liver (n=10 patients, 19.2%). Consolidation was observed in 36 patients (36%) and a pure ground-glass appearance was observed in 64 patients (64%) on CT. An increased opacity was observed on chest radiographs in 26 (72.2%) of 36 patients with consolidation. In 22 (34.3%) of 64 patients with ground-glass appearance, increased opacity was observed on chest radiography. The consolidation detection rate of chest radiography was significantly higher than that of ground glass (p < 0.01).

Conclusion: Low-density opacities and small-sized opacities reduce the effectiveness of chest radiography. Although Chest X-ray imaging is useful in detecting consolidations in pediatric patients, it was not sufficient to detect ground-glass appearances.