Occupational lung disease x ray

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Occupational lung disease Microchapters


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Case #1

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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]


A chest x-ray is the cornerstone of diagnosis in occupational lung disease. Findings on an x-ray suggestive of occupational lung disease include pleural thickening, pleural plaques, pleural abnormalities, calcification, small or large opacities, costophrenic angle obliteration, atelectasis, pneumothorax, parenchymal bands, enlarged hilar or mediastinal lymph nodes, bullae, and granulomata.

X Ray

X-ray findings for specific etiologies

X-ray findings depending on specific etiologies of occupational lung disease include:[2][3][4][5][6][7]

Silicosis and Talcosis

  • Multiple, small rounded opacities
  • Predilection to dorsal aspect of upper lobe
  • Diffuse ground glass opacities
  • Punctuate calcification in lymph nodes

Coal worker's pneumoconiosis


  • Predilection to lower lobes
  • Diaphragmatic plaques are pathognomonic
  • Fine and coarse linear, peripheral, reticular opacities


  • Multiple, rounded opacities with or without calcification
  • Architectural distortion
  • Loss of lung tissue volume
  • Shadows
  • Upper lobe predominance
  • Chronic berylliosis shows emphysema with bulla formation

Hypersensitivity pneumonitis

  • Starts at the lower lobes and moves progressively upwards
  • Reticular opacities with honeycombing

Vineyard sprayer's lung

  • Nodular opacities
  • Lobar consolidation
  • Upper lobe scarring
  • Conglomerate shadows
  • Lung destruction

Hard metal pneumoconiosis

  • Small nodules
  • Reticular opacities
  • Small cystic spaces
  • Basal predominance

Source:wikimediacommons, shows early asbestosis with plaques seen along the upper surface of the diaphragm by User Clinical Cases on en.wikipedia - Originally from en.wikipedia; description page is (was) here04:00, 5 March 2006 Clinical Cases 843x1024 (67110 bytes) (Source: Early Asbestosis in a Retired Pipe Fitter http://clinicalcases.blogspot.com/2004/03/early-asbestosis-in-retired-pipe.html Clinical_Cases: I made the photo myself, licensed under Creative Commons ), CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=729018


  1. Stark P, Jacobson F, Shaffer K (1992). "Standard imaging in silicosis and coal worker's pneumoconiosis". Radiol. Clin. North Am. 30 (6): 1147–54. PMID 1410305.
  2. Marchiori E, Lourenço S, Gasparetto TD, Zanetti G, Mano CM, Nobre LF (2010). "Pulmonary talcosis: imaging findings". Lung. 188 (2): 165–71. doi:10.1007/s00408-010-9230-y. PMID 20155272.
  3. Stark P (1981). "Vineyard sprayer's lung - a rare occupational disease". J Can Assoc Radiol. 32 (3): 183–4. PMID 7298709.
  4. Nemery B, Abraham JL (2007). "Hard metal lung disease: still hard to understand". Am. J. Respir. Crit. Care Med. 176 (1): 2–3. doi:10.1164/rccm.200704-527ED. PMID 17586761.
  5. Antao VC, Pinheiro GA, Terra-Filho M, Kavakama J, Müller NL (2005). "High-resolution CT in silicosis: correlation with radiographic findings and functional impairment". J Comput Assist Tomogr. 29 (3): 350–6. PMID 15891506.
  6. Dee P, Suratt P, Winn W (1978). "The radiographic findings in acute silicosis". Radiology. 126 (2): 359–63. doi:10.1148/126.2.359. PMID 622482.
  7. Blackley DJ, Reynolds LE, Short C, Carson R, Storey E, Halldin CN, Laney AS (2018). "Progressive Massive Fibrosis in Coal Miners From 3 Clinics in Virginia". JAMA. 319 (5): 500–501. doi:10.1001/jama.2017.18444. PMID 29411024.