Question

A 12-year-old child presents with an uncomplicated upper respiratory tract infection (URTI). What should be the next step regarding radiological imaging?

• A. No radiological investigation
• B. HRCT chest
• C. CECT chest
• D. Chest X-ray

Hint:

Uncomplicated URTI = clinical call; no red flags means no scan and no radiation.

Answer 1

The Correct Option is A

Step 1: Characterise the presentation.
A 12-year-old with an uncomplicated URTI has a self-limiting, predominantly viral illness diagnosed clinically. There is no indication of lower respiratory tract disease.

Step 2: Apply imaging appropriateness and radiation safety.
Guidelines do not recommend any radiological investigation for an uncomplicated URTI. Children are particularly radiosensitive, so the ALARA principle reinforces avoiding unnecessary imaging. Hence the next step is no radiological investigation.

Step 3: Eliminate the other options.
• Chest X-ray is appropriate only if pneumonia or lower-tract involvement is suspected — not for a simple URTI.
• HRCT evaluates interstitial lung disease/bronchiectasis and delivers high radiation; it is irrelevant here.
• CECT adds contrast and still more radiation, and is clearly inappropriate.

Step 4: Conclusion.
No imaging is warranted for an uncomplicated paediatric URTI. Key fact: URTI is a clinical diagnosis; image only if red-flag features of lower respiratory tract disease develop, sparing the child unnecessary radiation.