Lung Ultrasound versus Chest X-ray for Diagnosing Pulmonary Disorders in Neonatal Age Group: Review Article

Background: Neonatal respiratory conditions can arise for several reasons: delayed adaptation or maladaptation to extra-uterine life, existing conditions such as surgical or congenital anomalies, or acquired conditions such as pulmonary infections occurring either pre- or post-delivery. Respiratory conditions are the most common reason for admission to a neonatal unit in both term and preterm infants. The most common respiratory disorders include respiratory distress syndrome, pneumothorax, pneumonia, pulmonary hemorrhage, aspiration, pleural effusion, transient tachypnoea of the newborn, meconium aspiration, primary or secondary persistent pulmonary hypertension, congenital pulmonary airway malformation, congenital diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, pulmonary sequestration, and congenital lobar emphysema. Objective: This review article aims to evaluate the role of lung ultrasound (LUS) versus chest X-ray (CXR) for diagnosing pulmonary disorders in the neonatal age group, with a focus on identifying the most effective imaging modality. Conclusion: Chest imaging with X-ray (CXR) has high diagnostic potential in some disorders, such as respiratory distress syndrome in neonates. This technique also has the potential to assess the treatment response and evaluate the complications following treatment. No single imaging modality is superior for all neonatal respiratory conditions. CXR remains the standard for initial evaluation, while LUS is becoming a preferred choice for dynamic, bedside assessment. CT is valuable for complex or congenital cases where detailed imaging is crucial. The integration of these modalities ensures optimal care, guided by clinical context and radiological expertise.