Initially we would take a detailed history and examine the child. This would be followed by review of all old records and chest xrays if any. Most children may not need any further investigations.
In some children we would do a chest x-ray and a lung function test (breathing test). Older child can usually do a blowing type of lung function test also called as spirometry while in younger children we would do impulse oscillometry where the child just needs to breathe slowly in the lung function testing machine. These can be easily done by children.
Some children in addition might need a Xray of the sinuses and Xray for evaluation of adenoids, since sinusitis and adenoid hypertrophy can be associated or co-morbid with wheezing in children.
Some children might need further investigations to identify the cause of wheezing. These investigations include flexible bronchoscopy, CT scan of chest, investigations for Gastro-esophageal reflux, sweat chloride testing etc. Kids might need one or more of the mentioned investigations depending on a particular case. These are specialized investigations done at our division of pediatric pulmonology at BLK Super Specialty Hospital.