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== Overview ==
== Overview ==
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, the gold standard for diagnosis of adult bronchiolitis is clinical assessment. However, [[Spirometry|pulmonary function testing]], [[Computed tomography|high resolution computed tomography]] (HRCT), and [[bronchoscopy]] may be useful in the diagnosis of adult bronchiolitis.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
 
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, the gold standard for diagnosis of adult bronchiolitis is clinical assessment. However, [[Spirometry|pulmonary function testing]], [[Computed tomography|high resolution computed tomography]] (HRCT), and [[bronchoscopy]] may be useful in the diagnosis of adult bronchiolitis.<ref name="pmid20371529">{{cite journal |vauthors=Devakonda A, Raoof S, Sung A, Travis WD, Naidich D |title=Bronchiolar disorders: a clinical-radiological diagnostic algorithm |journal=Chest |volume=137 |issue=4 |pages=938–51 |date=April 2010 |pmid=20371529 |doi=10.1378/chest.09-0800 |url=}}</ref><ref name="pmid16037505">{{cite journal |vauthors=Pipavath SJ, Lynch DA, Cool C, Brown KK, Newell JD |title=Radiologic and pathologic features of bronchiolitis |journal=AJR Am J Roentgenol |volume=185 |issue=2 |pages=354–63 |date=August 2005 |pmid=16037505 |doi=10.2214/ajr.185.2.01850354 |url=}}</ref><ref name="pmid12475532">{{cite journal |vauthors=Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD |title=High-resolution CT features of severe asthma and bronchiolitis obliterans |journal=Clin Radiol |volume=57 |issue=12 |pages=1078–85 |date=December 2002 |pmid=12475532 |doi= |url=}}</ref><ref name="pmid24806161">{{cite journal |vauthors=Barker AF, Bergeron A, Rom WN, Hertz MI |title=Obliterative bronchiolitis |journal=N. Engl. J. Med. |volume=370 |issue=19 |pages=1820–8 |date=May 2014 |pmid=24806161 |doi=10.1056/NEJMra1204664 |url=}}</ref><ref name="pmid18339530">{{cite journal |vauthors=Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM, Shamsaei H, Bahadori M, Aslani J, Mohammadi A |title=An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients |journal=Respir Med |volume=102 |issue=6 |pages=825–30 |date=June 2008 |pmid=18339530 |doi=10.1016/j.rmed.2008.01.016 |url=}}</ref>
===== Template statements =====
 
=== Study of choice: ===
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The following result of [gold standard test] is confirmatory of [disease name]:
** Result 1
** Result 2
* The [name of the investigation] should be performed when:
** The patient presented with symptoms/signs 1. 2, 3.
** A positive [test] is detected in the patient.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The diagnostic study of choice for [disease name] is [name of the investigation].
* There is no single diagnostic study of choice for the diagnosis of [disease name].
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* [Disease name] is mainly diagnosed based on clinical presentation.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison table for diagnostic studies of choice for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
|}
<small> ✔= The best test based on the feature </small>


===== Diagnostic results =====
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
*The following result of pulmonary function test is suggestive of adult bronchiolitis:
* Result 1
**Normal [[Spirometry|PFT]] ''or''
* Result 2
**Obstructive or restrictive changes with [[atelectasis]]
**Irreversibility following inhaled bronchodilator
**Decreased [[Diffusion capacity|carbon monoxide diffusing capacity]]
*The following result of high resolution CT is suggestive of adult bronchiolitis:
**Mosaic or diffuse air trapping
**Bronchial wall thickening
**Linear opacities
**Centrilobular nodules
**[[Bronchiectasis]] (dilated airways)
***Specifically seen in:
****Bronchiolitis obliterans
****Following lung transplant
****[[Rheumatoid arthritis|Rheumatic disease]]
****Previous infection
****Toxic fume inhalation
*Bronchoscopy does not have any specific findings that suggest adult bronchiolitis, however, [[bronchoscopy]] may be useful for:
**Identifying features of other respiratory pathologies, such as:
***Increased lymphocytic count in [[hypersensitivity pneumonitis]]
***Necrotizing granulomata in [[sarcoidosis]]
***Infection
***Malignancy
***Lung transplant function deterioration causes


===== Sequence of Diagnostic Studies =====
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
*The investigation fro adult bronchiolitis should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
**The patient presented with insidious onset of [[cough]] and [[dyspnea]], with a pattern unlike [[Chronic obstructive pulmonary disease|chronic obstructive pulmonary disorder]] and [[asthma]].
* A positive [test] is detected in the patient, to confirm the diagnosis.


=== Diagnostic Criteria ===
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
There are no established criteria for the diagnosis of adult bronchiolitis.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
 
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


==References==
==References==
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[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Occupational diseases]]
[[Category:Occupational diseases]]
[[Category:Disease]]
[[Category:Medicine]]
[[Category:Up-To-Date]]
[[Category:Primary Care]]
[[Category:Radiology]]

Latest revision as of 14:36, 15 March 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, the gold standard for diagnosis of adult bronchiolitis is clinical assessment. However, pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.

Diagnostic Study of Choice

There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, the gold standard for diagnosis of adult bronchiolitis is clinical assessment. However, pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.[1][2][3][4][5]

Diagnostic results
  • The following result of pulmonary function test is suggestive of adult bronchiolitis:
  • The following result of high resolution CT is suggestive of adult bronchiolitis:
    • Mosaic or diffuse air trapping
    • Bronchial wall thickening
    • Linear opacities
    • Centrilobular nodules
    • Bronchiectasis (dilated airways)
      • Specifically seen in:
        • Bronchiolitis obliterans
        • Following lung transplant
        • Rheumatic disease
        • Previous infection
        • Toxic fume inhalation
  • Bronchoscopy does not have any specific findings that suggest adult bronchiolitis, however, bronchoscopy may be useful for:
    • Identifying features of other respiratory pathologies, such as:
Sequence of Diagnostic Studies

Diagnostic Criteria

There are no established criteria for the diagnosis of adult bronchiolitis.

References

  1. ↑ Devakonda A, Raoof S, Sung A, Travis WD, Naidich D (April 2010). "Bronchiolar disorders: a clinical-radiological diagnostic algorithm". Chest. 137 (4): 938–51. doi:10.1378/chest.09-0800. PMID 20371529.
  2. ↑ Pipavath SJ, Lynch DA, Cool C, Brown KK, Newell JD (August 2005). "Radiologic and pathologic features of bronchiolitis". AJR Am J Roentgenol. 185 (2): 354–63. doi:10.2214/ajr.185.2.01850354. PMID 16037505.
  3. ↑ Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD (December 2002). "High-resolution CT features of severe asthma and bronchiolitis obliterans". Clin Radiol. 57 (12): 1078–85. PMID 12475532.
  4. ↑ Barker AF, Bergeron A, Rom WN, Hertz MI (May 2014). "Obliterative bronchiolitis". N. Engl. J. Med. 370 (19): 1820–8. doi:10.1056/NEJMra1204664. PMID 24806161.
  5. ↑ Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM, Shamsaei H, Bahadori M, Aslani J, Mohammadi A (June 2008). "An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients". Respir Med. 102 (6): 825–30. doi:10.1016/j.rmed.2008.01.016. PMID 18339530.
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