Consider CXR if concerned about alternative diagnosis
In typical cases, imaging is not needed and does not change management
Steeple sign on AP XR (not specific or sensitive)
Consider nasal pharyngeal swab
In typical cases, imaging is not needed and does not change management
Steeple sign on AP XR (not specific or sensitive)
Clinical
Steeple sign unreliable
Steeple sign unreliable
Helps to stratify patients into mild moderate and severe and guide treatment
Assessment
<2 Very mild
2-6 Mild to moderately severe
7-11 Severe<unk> 
≥ 12 Respiratory failure
Croup
Laryngotracheomalacia
Laryngitis
Accounts for 60%
Sinusitis
Usually exacerbated by viral URI
Epiglottitis
Dx w/ flexible fiberoptic laryngoscopy