POCUS Examination of the Mediastinum in Children: A Simplified and Standardized Protocol for Pulmonary Tuberculosis.

BACKGROUND

Point of care ultrasound (POCUS) is increasingly recognized as a valuable tool for mediastinal assessment in children, particularly in resource-limited settings where advanced radiological options such as computed tomography (CT) scans are often unavailable. In high-income countries, POCUS is gaining traction as a complementary imaging method, offering a safer, radiation-free alternative.

METHODS

To overcome the operator-dependent nature of mediastinal POCUS, a standardized protocol was developed. The protocol includes clear techniques and detailed descriptions of normal and pathological findings, aiming to enhance consistency and diagnostic accuracy.

RESULTS

The standardized protocol improved reliability in mediastinal POCUS assessments, especially in the context of paediatric pulmonary tuberculosis, a condition often marked by lymph node involvement. Given the challenges of obtaining respiratory samples in children and their typically low diagnostic yield, POCUS emerged as a particularly suitable diagnostic modality.

CONCLUSIONS

Mediastinal POCUS, guided by a standardized protocol, represents a safe, affordable, point-of-care, and non-ionizing option for identifying mediastinal lymphadenopathy. Its application holds promise for improving the diagnosis of paediatric tuberculosis, especially in settings with limited access to advanced radiological imaging.