Pneumoconiosis diagnostic criteria: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(39 intermediate revisions by the same user not shown)
Line 3: Line 3:
{{CMG}}; {{AE}} [[User:Dushka|Dushka Riaz, MD]]
{{CMG}}; {{AE}} [[User:Dushka|Dushka Riaz, MD]]


== Overview ==
==Overview==
The initial imaging done for [[pneumoconiosis]] is a [[Chest X-ray|chest x-ray]]. This serves as a [[screening test]]. [[High-resolution CT]] follows and is more [[Sensitivity (test)|sensitive]] and [[Specificity|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]]. <ref name="pmid1410306">{{cite journal| author=Remy-Jardin M, Remy J, Farre I, Marquette CH| title=Computed tomographic evaluation of silicosis and coal workers' pneumoconiosis. | journal=Radiol Clin North Am | year= 1992 | volume= 30 | issue= 6 | pages= 1155-76 | pmid=1410306 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1410306  }} </ref> <ref name="pmid1987601">{{cite journal| author=Akira M, Yokoyama K, Yamamoto S, Higashihara T, Morinaga K, Kita N | display-authors=etal| title=Early asbestosis: evaluation with high-resolution CT. | journal=Radiology | year= 1991 | volume= 178 | issue= 2 | pages= 409-16 | pmid=1987601 | doi=10.1148/radiology.178.2.1987601 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1987601  }} </ref> <ref name="pmid14576443">{{cite journal| author=Copley SJ, Wells AU, Sivakumaran P, Rubens MB, Lee YC, Desai SR | display-authors=etal| title=Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features. | journal=Radiology | year= 2003 | volume= 229 | issue= 3 | pages= 731-6 | pmid=14576443 | doi=10.1148/radiol.2293020668 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14576443  }} </ref> <ref name="pmid33153681">{{cite journal| author=Walkoff L, Hobbs S| title=Chest Imaging in the Diagnosis of Occupational Lung Diseases. | journal=Clin Chest Med | year= 2020 | volume= 41 | issue= 4 | pages= 581-603 | pmid=33153681 | doi=10.1016/j.ccm.2020.08.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33153681  }} </ref>


== Diagnostic Study of Choice ==
==Diagnostic Study of Choice==


=== 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. <ref name="pmid23034792">{{cite journal| author=Darnton A, Hodgson J, Benson P, Coggon D| title=Mortality from asbestosis and mesothelioma in Britain by birth cohort. | journal=Occup Med (Lond) | year= 2012 | volume= 62 | issue= 7 | pages= 549-52 | pmid=23034792 | doi=10.1093/occmed/kqs119 | pmc=3471357 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23034792  }} </ref> <ref name="pmid9322824">{{cite journal| author=| title=Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution. | journal=Scand J Work Environ Health | year= 1997 | volume= 23 | issue= 4 | pages= 311-6 | pmid=9322824 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9322824  }} </ref>
[[Image:Asbestosis-5.jpg|right|Asbestosis]]


[[Image:Asbestosis-5.jpg|thumb|200px|left|Asbestosis with pleural plaques - Case courtesy of Dr Hani Makky Al Salam, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/45002">rID: 45002</a>]]


2. The best test for Silicosis is a high resolution CT:
1. Radiologic tests must be performed to test for [[asbestosis]] when:
*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>


Investigations:
*The patient has had exposure to [[asbestos]] (with Helsinki criteria indicating the dose being at least 25 fibre/ml.years)
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
*The [[CT scan]] would show [[pulmonary fibrosis]], pleural thickening and pleural plaques. <ref name="pmid23034792">{{cite journal| author=Darnton A, Hodgson J, Benson P, Coggon D| title=Mortality from asbestosis and mesothelioma in Britain by birth cohort. | journal=Occup Med (Lond) | year= 2012 | volume= 62 | issue= 7 | pages= 549-52 | pmid=23034792 | doi=10.1093/occmed/kqs119 | pmc=3471357 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23034792  }} </ref> <ref name="pmid9322824">{{cite journal| author=| title=Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution. | journal=Scand J Work Environ Health | year= 1997 | volume= 23 | issue= 4 | pages= 311-6 | pmid=9322824 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9322824  }}</ref>
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.


===== Sequence of Diagnostic Studies =====
2. The best test for [[silicosis]] is a [[High Resolution CT|high resolution CT]]:
The various investigations must be performed in the following order:
* [Initial investigation]
* [2nd investigation]


=== Diagnostic Criteria ===
*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, and 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>
 
3. [[Coal worker's pneumoconiosis]] also presents similarly to [[silicosis]] on [[HRCT]]:
 
*[[Nodular]] opacities are seen with preference for upper lobes as well as massive [[pulmonary fibrosis]]. <ref name="pmid2217770">{{cite journal| author=Remy-Jardin M, Degreef JM, Beuscart R, Voisin C, Remy J| title=Coal worker's pneumoconiosis: CT assessment in exposed workers and correlation with radiographic findings. | journal=Radiology | year= 1990 | volume= 177 | issue= 2 | pages= 363-71 | pmid=2217770 | doi=10.1148/radiology.177.2.2217770 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2217770  }} </ref>
 
4. [[Berylliosis]] cases should have testing completed as well:
 
*A blood beryllium lymphocyte proliferation test is the screening test of choice for those suspected of [[berylliosis]]. <ref name="pmid25398119">{{cite journal| author=Balmes JR, Abraham JL, Dweik RA, Fireman E, Fontenot AP, Maier LA | display-authors=etal| title=An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease. | journal=Am J Respir Crit Care Med | year= 2014 | volume= 190 | issue= 10 | pages= e34-59 | pmid=25398119 | doi=10.1164/rccm.201409-1722ST | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25398119  }} </ref>
*CT scans would show [[Ground glass opacification on CT|ground glass opacities]] as the earliest sign. <ref name="pmid12362066">{{cite journal| author=Maier LA| title=Clinical approach to chronic beryllium disease and other nonpneumoconiotic interstitial lung diseases. | journal=J Thorac Imaging | year= 2002 | volume= 17 | issue= 4 | pages= 273-84 | pmid=12362066 | doi=10.1097/00005382-200210000-00004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12362066  }} </ref> <ref name="pmid21084914">{{cite journal| author=Sharma N, Patel J, Mohammed TL| title=Chronic beryllium disease: computed tomographic findings. | journal=J Comput Assist Tomogr | year= 2010 | volume= 34 | issue= 6 | pages= 945-8 | pmid=21084914 | doi=10.1097/RCT.0b013e3181ef214e | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21084914  }} </ref>
 
===Diagnostic Criteria===
 
To be qualified as a [[pneumoconiosis]] or [[occupational disease]] there must be four criteria met:


To be qualified as a pneumoconiosis or [[occupational disease]] there must be four criteria met:
*This includes documented exposure to the particle.
*This includes documented exposure to the particle.
*[[Latent period]] before the development of [[symptoms]].
*[[Latent period]] before the development of [[symptoms]].

Latest revision as of 23:00, 26 April 2021

Pneumoconiosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pneumoconiosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pneumoconiosis diagnostic criteria On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pneumoconiosis diagnostic criteria

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pneumoconiosis diagnostic criteria

CDC on Pneumoconiosis diagnostic criteria

Pneumoconiosis diagnostic criteria in the news

Blogs on Pneumoconiosis diagnostic criteria

Directions to Hospitals Treating Pneumoconiosis

Risk calculators and risk factors for Pneumoconiosis diagnostic criteria

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

Asbestosis with pleural plaques - Case courtesy of Dr Hani Makky Al Salam, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/45002">rID: 45002</a>

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:

3. Coal worker's pneumoconiosis also presents similarly to silicosis on HRCT:

4. Berylliosis cases should have testing completed as well:

Diagnostic Criteria

To be qualified as a pneumoconiosis or occupational disease there must be four criteria met:

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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).
  5. ↑ 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.
  6. ↑ "Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution". Scand J Work Environ Health. 23 (4): 311–6. 1997. PMID 9322824.
  7. ↑ Cullinan P, Reid P (2013). "Pneumoconiosis". Prim Care Respir J. 22 (2): 249–52. doi:10.4104/pcrj.2013.00055. PMC 6442808. PMID 23708110.
  8. ↑ Remy-Jardin M, Degreef JM, Beuscart R, Voisin C, Remy J (1990). "Coal worker's pneumoconiosis: CT assessment in exposed workers and correlation with radiographic findings". Radiology. 177 (2): 363–71. doi:10.1148/radiology.177.2.2217770. PMID 2217770.
  9. ↑ Balmes JR, Abraham JL, Dweik RA, Fireman E, Fontenot AP, Maier LA; et al. (2014). "An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease". Am J Respir Crit Care Med. 190 (10): e34–59. doi:10.1164/rccm.201409-1722ST. PMID 25398119.
  10. ↑ Maier LA (2002). "Clinical approach to chronic beryllium disease and other nonpneumoconiotic interstitial lung diseases". J Thorac Imaging. 17 (4): 273–84. doi:10.1097/00005382-200210000-00004. PMID 12362066.
  11. ↑ Sharma N, Patel J, Mohammed TL (2010). "Chronic beryllium disease: computed tomographic findings". J Comput Assist Tomogr. 34 (6): 945–8. doi:10.1097/RCT.0b013e3181ef214e. PMID 21084914.
  12. ↑ Epler GR (1992). "Clinical overview of occupational lung disease". Radiol Clin North Am. 30 (6): 1121–33. PMID 1410303.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Pneumoconiosis_diagnostic_criteria&oldid=1698863"