The complete evaluation of strider in infants requires a careful histo
ry and physical examination, and appropriate radiographic studies. Exa
mination of the upper airway is appropriate in symptomatic patients. P
remature infants are especially at risk for subglottic mucosal injury
if intubation is required. Compromise of the subglottic space by vario
us lesions may result in biphasic strider due to a fixed obstruction,
and other symptoms may include recurrent croup, cyanosis, apnea, feedi
ng difficulty, and failure to thrive. Although not diagnostic, soft ti
ssue radiographs of the neck may aid in suggesting a diagnosis before
endoscopy.