Editing Pneumonia (section)

===Imaging===
[[File:X-ray of lobar pneumonia.jpg|thumb|A chest X-ray showing a very prominent wedge-shaped area of airspace consolidation in the right lung characteristic of acute bacterial lobar pneumonia]]
[[File:CT scan of the chest, demonstrating right-sided pneumonia.jpg|thumb|alt=A black-and-white image shows the internal organs in cross-section as generated by CT. Where one would expect black on the left, one sees a whiter area with black sticks through it.|CT of the chest demonstrating right-sided pneumonia (left side of the image)]]
A [[chest radiograph]] is frequently used in diagnosis.<ref name=Develop11/> In people with mild disease, imaging is needed only in those with potential complications, those not having improved with treatment, or those in which the cause is uncertain.<ref name=Develop11/><ref name=BTS09>{{cite journal | vauthors = Lim WS, Baudouin SV, George RC, Hill AT, Jamieson C, Le Jeune I, Macfarlane JT, Read RC, Roberts HJ, Levy ML, Wani M, Woodhead MA | title = BTS guidelines for the management of community acquired pneumonia in adults: update 2009 | journal = Thorax | volume = 64 | issue = Suppl 3 | pages = iii, 1–55 | date = October 2009 | pmid = 19783532 | doi = 10.1136/thx.2009.121434 | doi-access = free }}</ref> If a person is sufficiently sick to require hospitalization, a chest radiograph is recommended.<ref name=BTS09/> Findings do not always match the severity of disease and do not reliably separate between bacterial and viral infection.<ref name=Develop11/>

X-ray presentations of pneumonia may be classified as [[lobar pneumonia]], [[bronchopneumonia]], [[lobular pneumonia]], and [[interstitial pneumonia]].<ref>{{cite book | editor-last1 = Helms | editor-first1 = Clyde A. | editor-last2=Brant | editor-first2 = William E. | title = Fundamentals of diagnostic radiology | publisher = Wolters Kluwer/Lippincott Williams & Wilkins | location=Philadelphia | isbn=978-1-60831-911-4 | page=435 | url=https://books.google.com/books?id=o_4eoeOinNgC&pg=PA435 | edition=4th | date=20 March 2012}}</ref> Bacterial, community-acquired pneumonia classically show [[lung consolidation]] of one [[Bronchopulmonary segment|lung segmental lobe]], which is known as lobar pneumonia.<ref name=Rad07/> However, findings may vary, and other patterns are common in other types of pneumonia.<ref name=Rad07/> Aspiration pneumonia may present with bilateral opacities primarily in the bases of the lungs and on the right side.<ref name=Rad07/> Radiographs of viral pneumonia may appear normal, appear hyper-inflated, have bilateral patchy areas, or present similar to bacterial pneumonia with lobar consolidation.<ref name=Rad07/> Radiologic findings may not be present in the early stages of the disease, especially in the presence of dehydration, or may be difficult to interpret in the [[obesity|obese]] or those with a history of lung disease.<ref name=Clinic2011/> Complications such as pleural effusion may also be found on chest radiographs. Laterolateral chest radiographs can increase the diagnostic accuracy of lung consolidation and pleural effusion.<ref name="Elena 2015"/>

A [[CT scan]] can give additional information in indeterminate cases<ref name=Rad07/> and provide more details in those with an unclear chest radiograph (for example occult pneumonia in chronic obstructive pulmonary disease). They can be used to exclude [[pulmonary embolism]] and [[fungal pneumonia]], and detect lung abscesses in those who are not responding to treatments.<ref name="Elena 2015"/> However, CT scans are more expensive, have a higher dose of radiation, and cannot be done at bedside.<ref name="Elena 2015"/>

[[Lung ultrasound]] may also be useful in helping to make the diagnosis.<ref>{{cite journal |vauthors=Llamas-Álvarez AM, Tenza-Lozano EM, Latour-Pérez J |date=February 2017 |title=Accuracy of Lung Ultrasonography in the Diagnosis of Pneumonia in Adults: Systematic Review and Meta-Analysis |url=https://journal.chestnet.org/article/S0012-3692(16)62327-9/fulltext |journal=Chest |volume=151 |issue=2 |pages=374–82 |doi=10.1016/j.chest.2016.10.039 |pmid=27818332 |s2cid=24399240}}</ref> Ultrasound is radiation free and can be done at bedside. However, ultrasound requires specific skills to operate the machine and interpret the findings.<ref name="Elena 2015"/> It may be more accurate than chest X-ray.<ref>{{cite journal | vauthors = Ye X, Xiao H, Chen B, Zhang S | title = Accuracy of Lung Ultrasonography versus Chest Radiography for the Diagnosis of Adult Community-Acquired Pneumonia: Review of the Literature and Meta-Analysis | journal = PLOS ONE| volume = 10 | issue = 6 | pages = e0130066 | date = 2015 | pmid = 26107512 | pmc = 4479467 | doi = 10.1371/journal.pone.0130066 | bibcode = 2015PLoSO..1030066Y | doi-access = free }}</ref>

<gallery>
File:UOTW 34 - Ultrasound of the Week 1.webm|Pneumonia seen by ultrasound<ref name=UOTW34>{{cite web|title=UOTW No. 34 – Ultrasound of the Week|url=https://www.ultrasoundoftheweek.com/uotw-34/|website=Ultrasound of the Week|access-date=27 May 2017|date=20 January 2015|url-status=live|archive-url=https://web.archive.org/web/20170509114431/https://www.ultrasoundoftheweek.com/uotw-34/|archive-date=9 May 2017}}</ref>
File:UOTW 34 - Ultrasound of the Week 2.webm|Pneumonia seen by ultrasound<ref name=UOTW34/>
File:UOTW 34 - Ultrasound of the Week 3.jpg|Pneumonia seen by ultrasound<ref name=UOTW34/>
File:RtPneuKidMark.png|Right middle lobe pneumonia in a child as seen on plain X-ray
</gallery>