Chest radiography for children with pneumonia: a century of folly?

form of radiation in 1895(1), the excitement was immediate, and a radiology handbook was published within a year(2). Screening of apparently healthy people was being recommended by 1928(3), and the US Army and Navy screened approximately 10 million personnel during World War II(4). In 1980 alone an estimated 30 million routine admission chest x-rays were taken in the United States, costing consumers $1.5 billion(5). The development of the scientific basis for the use of chest radiography has however received little attention. Recognition of inter-observer variation took almost 50 years(6), and widespread acceptance even longer(7). In the centennial of Roentgen’s discovery, a prestigious radiological journal published a paper stating that, “As the most common radiographic examination, the chest radiographic examination rose to this position not on the basis of medical science but faith that technology in any form would aid in the care of patients”(8).