Pneumoconiosis diagnostic criteria
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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 diseases missed by chest radiograph. Pathognomonic for asbestosis is pleural thickening with pleural plaques. Silicosis would show round opacities in the upper lung. Massive fibrosis can be seen in both coal worker's pneumoconiosis and silicosis. [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.