Imaging

Pneumoconiosis

Preliminary Diagnosis: Pneumoconiosis

I. What imaging technique is first-line for this diagnosis?

Chest x-ray, PA, and lateral view.

II. Describe the advantages and disadvantages of this technique for diagnosing pneumoconiosis.

Advantages

  • Relatively inexpensive and fast imaging modality.

  • Highly portable.

  • Exposes patients to negligible ionizing radiation.

Disadvantages

  • Less sensitive and specific in evaluating for pneumoconiosis compared to CT imaging.

  • Less sensitive and specific in detecting or characterizing an underlying pulmonary or parenchymal process or detailing a secondary complication in comparison to CT imaging.

III. What are the contraindications for the first-line imaging technique?

No specific contraindications to plain radiography exist.

IV. What alternative imaging techniques are available?

CT of the chest, with and without contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing pneumoconiosis.

Advantages

  • More sensitive and specific in detecting and characterizing an underlying parenchymal or pulmonary process or secondary complication compared to plain radiography.

  • Offers exquisite detail of the parenchymal architecture, including the interlobular septa and secondary pulmonary lobule.

  • May help guide treatment.

Disadvantages

  • Exposure to ionizing radiation.

  • Less portable than plain radiography.

VI. What are the contraindications for the alternative imaging techniques?

  • May be contraindicated in pregnant patients.

  • Contrast relatively contraindicated in patients with renal failure or those with an allergy to the contrast.

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