Pneumoconiosis differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Pneumoconiosis must be differentiated from other diseases that cause chronic cough and dyspnea. | [[Pneumoconiosis]] must be differentiated from other diseases that cause chronic [[cough]] and [[dyspnea]]. | ||
==Differentiating Pneumoconiosis from other Diseases== | ==Differentiating Pneumoconiosis from other Diseases== | ||
Pneumoconiosis must be differentiated from other diseases that cause cough and dyspnea. | [[Pneumoconiosis]] must be differentiated from other diseases that cause [[cough]] and [[dyspnea]]. | ||
===Differentiating pneumoconiosis from other diseases on the basis of dyspnea and cough=== | ===Differentiating pneumoconiosis from other diseases on the basis of dyspnea and cough=== | ||
On the basis of cough and chronic dyspnea, pneumoconiosis must be differentiated from lung malignancy, tuberculosis, emphysema, asthma, interstitial lung disease, pneumonia, and sarcoidosis. | On the basis of [[cough]] and chronic [[dyspnea]], [[pneumoconiosis]] must be differentiated from [[Lung cancer|lung malignancy]], [[tuberculosis]], [[emphysema]], [[asthma]], [[interstitial lung disease]], [[pneumonia]], and [[sarcoidosis]]. | ||
{| | {| | ||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Imaging | ||
|- | |- | ||
|Pneumoconiosis | |[[Pneumoconiosis]] | ||
| + | | + | ||
| + | | + | ||
| + | | + | ||
|↑ FEV1/FVC | |[[FEV1/FVC ratio|↑ FEV1/FVC]] | ||
|Wheezing, rhonchi, crackles | |Wheezing, rhonchi, crackles | ||
| + | | + | ||
| Line 47: | Line 47: | ||
|HRCT | |HRCT | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Lung Malignancy | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lung cancer|Lung Malignancy]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" |↓[[Tidal volume|Vt]], ↑[[Residual volume|RV]] | ||
| style="background: #F5F5F5; padding: 5px;" |Wheezing, crackles | | style="background: #F5F5F5; padding: 5px;" |Wheezing, crackles | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| Line 59: | Line 59: | ||
| style="background: #F5F5F5; padding: 5px;" |Bronchoscopy | | style="background: #F5F5F5; padding: 5px;" |Bronchoscopy | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Tuberculosis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tuberculosis]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |Restrictive, obstructive, or mixed | | style="background: #F5F5F5; padding: 5px;" |[[Restrictive Lung Disease|Restrictive]], [[Obstructive Lung Disease|obstructive]], or mixed | ||
| style="background: #F5F5F5; padding: 5px;" |Wheezing, rhonchi, crackles | | style="background: #F5F5F5; padding: 5px;" |Wheezing, rhonchi, crackles | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
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| style="background: #F5F5F5; padding: 5px;" |IFN-y assay and acid fast stain | | style="background: #F5F5F5; padding: 5px;" |IFN-y assay and acid fast stain | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Emphysema | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Emphysema]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |↓ FEV1/FVC | | style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1/FVC ratio|FEV1/FVC]] | ||
| style="background: #F5F5F5; padding: 5px;" |Wheezing | | style="background: #F5F5F5; padding: 5px;" |Wheezing | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
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| style="background: #F5F5F5; padding: 5px;" |Physical exam, spirometry | | style="background: #F5F5F5; padding: 5px;" |Physical exam, spirometry | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Asthma | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Asthma]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |↓ FEV1/FVC | | style="background: #F5F5F5; padding: 5px;" |↓ [[FEV1/FVC ratio|FEV1/FVC]] | ||
| style="background: #F5F5F5; padding: 5px;" |Wheezing | | style="background: #F5F5F5; padding: 5px;" |Wheezing | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
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| style="background: #F5F5F5; padding: 5px;" |Physical exam, spirometry before and after brondchodilator | | style="background: #F5F5F5; padding: 5px;" |Physical exam, spirometry before and after brondchodilator | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Interstitial lung diseases | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Interstitial lung disease|Interstitial lung diseases]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |↑ FEV1/FVC | | style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1/FVC ratio|FEV1/FVC]] | ||
| style="background: #F5F5F5; padding: 5px;" |Wheezing, rhonchi, crackles | | style="background: #F5F5F5; padding: 5px;" |Wheezing, rhonchi, crackles | ||
| style="background: #F5F5F5; padding: 5px;" | +/- | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
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| style="background: #F5F5F5; padding: 5px;" |HRCT | | style="background: #F5F5F5; padding: 5px;" |HRCT | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Sarcoidosis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sarcoidosis]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | - | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |↑ FEV1/FVC | | style="background: #F5F5F5; padding: 5px;" |↑ [[FEV1/FVC ratio|FEV1/FVC]] | ||
| style="background: #F5F5F5; padding: 5px;" |Crackles | | style="background: #F5F5F5; padding: 5px;" |Crackles | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
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| style="background: #F5F5F5; padding: 5px;" |HRCT | | style="background: #F5F5F5; padding: 5px;" |HRCT | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pneumonia | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pneumonia]] | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" | + | | style="background: #F5F5F5; padding: 5px;" | + | ||
Revision as of 21:28, 30 April 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD
Overview
Pneumoconiosis must be differentiated from other diseases that cause chronic cough and dyspnea.
Differentiating Pneumoconiosis from other Diseases
Pneumoconiosis must be differentiated from other diseases that cause cough and dyspnea.
Differentiating pneumoconiosis from other diseases on the basis of dyspnea and cough
On the basis of cough and chronic dyspnea, pneumoconiosis must be differentiated from lung malignancy, tuberculosis, emphysema, asthma, interstitial lung disease, pneumonia, and sarcoidosis.
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | |||||||||
| Lab Findings | Imaging | |||||||||
| Chronic Dyspnea | Cough | Fever | Spirometry | Auscultation | Night Sweats | CBC | ABG | Imaging | ||
| Pneumoconiosis | + | + | + | ↑ FEV1/FVC | Wheezing, rhonchi, crackles | + | ↑WBC | ↓O2, ↑CO2 | Massive fibrosis, hilar adenopathy, reticular opacities, pleural plaques | HRCT |
| Lung Malignancy | + | + | - | ↓Vt, ↑RV | Wheezing, crackles | + | Normal | Normal | Mass lesion, hilar lymphadenopathy | Bronchoscopy |
| Tuberculosis | + | + | + | Restrictive, obstructive, or mixed | Wheezing, rhonchi, crackles | + | ↑WBC | ↓O2, ↑CO2 | Patchy consolidation, nodular opacities | IFN-y assay and acid fast stain |
| Emphysema | + | + | - | ↓ FEV1/FVC | Wheezing | - | Normal | Respiratory alkalosis, Metabolic acidosis | Flat diaphragm | Physical exam, spirometry |
| Asthma | + | + | - | ↓ FEV1/FVC | Wheezing | - | ↑ Eosinophil | Respiratory alkalosis, Metabolic acidosis | Normal | Physical exam, spirometry before and after brondchodilator |
| Interstitial lung diseases | + | + | - | ↑ FEV1/FVC | Wheezing, rhonchi, crackles | +/- | Normal | ↓O2, ↑CO2 | Peripheral pulmonary infiltrative opacification | HRCT |
| Sarcoidosis | + | + | - | ↑ FEV1/FVC | Crackles | + | Normal | ↓O2, ↑CO2 | Hilar adenopathy | HRCT |
| Pneumonia | + | + | + | Normal | Wheezing, rhonchi, crackles | + | ↑WBC, neutrophilia | Normal | Lobar consolidation | CXR, CT Scan |