Pneumoconiosis diagnostic criteria: Difference between revisions
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2. The best test for Silicosis is a high resolution CT: | 2. The best test for Silicosis is a high resolution CT: | ||
*It would show widespread fibrosis with bilateral nodules and evidence of involvement of lymph nodes. It can be confirmed with lung biopsy showing acellular whorls, bi-refringent crystals of silica. <ref name="pmid23708110">{{cite journal| author=Cullinan P, Reid P| title=Pneumoconiosis. | journal=Prim Care Respir J | year= 2013 | volume= 22 | issue= 2 | pages= 249-52 | pmid=23708110 | doi=10.4104/pcrj.2013.00055 | pmc=6442808 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23708110 }} </ref> | *It would show widespread fibrosis with bilateral nodules and evidence of involvement of lymph nodes. It can be confirmed with lung biopsy showing acellular whorls, bi-refringent crystals of silica. <ref name="pmid23708110">{{cite journal| author=Cullinan P, Reid P| title=Pneumoconiosis. | journal=Prim Care Respir J | year= 2013 | volume= 22 | issue= 2 | pages= 249-52 | pmid=23708110 | doi=10.4104/pcrj.2013.00055 | pmc=6442808 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23708110 }} </ref> | ||
===== Sequence of Diagnostic Studies ===== | ===== Sequence of Diagnostic Studies ===== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD
Overview
The initial imaging done for pneumoconiosis is a chest x-ray. This serves as a screening test. High resolution CT follows and is more sensitive and specific. HRCT can identify those disease missed by chest radiograph. [1] [2] [3] [4]
Diagnostic Study of Choice
Study of choice
1. Radiologic tests must be performed to test for asbestosis when:
- The patient has had exposure to asbestos (with Helsinki criteria indicating the dose being at least 25 fibre/ml.years.
- The CT scan would show pulmonary fibrosis, pleural thickening and pleural plaques. [5] [6]
2. The best test for Silicosis is a high resolution CT:
- It would show widespread fibrosis with bilateral nodules and evidence of involvement of lymph nodes. It can be confirmed with lung biopsy showing acellular whorls, bi-refringent crystals of silica. [7]
Sequence of Diagnostic Studies
The various investigations must be performed in the following order:
- [Initial investigation]
- [2nd investigation]
Diagnostic Criteria
To be qualified as a pneumoconiosis or occupational disease there must be four criteria met:
- This includes documented exposure to the particle.
- Latent period before the development of symptoms.
- Clinical signs and symptoms that entail the disease
- Exclusion of other disease modalities. [8]
References
- ↑ Remy-Jardin M, Remy J, Farre I, Marquette CH (1992). "Computed tomographic evaluation of silicosis and coal workers' pneumoconiosis". Radiol Clin North Am. 30 (6): 1155–76. PMID 1410306.
- ↑ Akira M, Yokoyama K, Yamamoto S, Higashihara T, Morinaga K, Kita N; et al. (1991). "Early asbestosis: evaluation with high-resolution CT". Radiology. 178 (2): 409–16. doi:10.1148/radiology.178.2.1987601. PMID 1987601.
- ↑ Copley SJ, Wells AU, Sivakumaran P, Rubens MB, Lee YC, Desai SR; et al. (2003). "Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features". Radiology. 229 (3): 731–6. doi:10.1148/radiol.2293020668. PMID 14576443.
- ↑ Walkoff L, Hobbs S (2020). "Chest Imaging in the Diagnosis of Occupational Lung Diseases". Clin Chest Med. 41 (4): 581–603. doi:10.1016/j.ccm.2020.08.007. PMID 33153681 Check
|pmid=value (help). - ↑ Darnton A, Hodgson J, Benson P, Coggon D (2012). "Mortality from asbestosis and mesothelioma in Britain by birth cohort". Occup Med (Lond). 62 (7): 549–52. doi:10.1093/occmed/kqs119. PMC 3471357. PMID 23034792.
- ↑ "Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution". Scand J Work Environ Health. 23 (4): 311–6. 1997. PMID 9322824.
- ↑ Cullinan P, Reid P (2013). "Pneumoconiosis". Prim Care Respir J. 22 (2): 249–52. doi:10.4104/pcrj.2013.00055. PMC 6442808. PMID 23708110.
- ↑ Epler GR (1992). "Clinical overview of occupational lung disease". Radiol Clin North Am. 30 (6): 1121–33. PMID 1410303.