Chest ImagingPub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0059
Felipe Martinez
{"title":"Rheumatoid Arthritis","authors":"Felipe Martinez","doi":"10.1093/med/9780199858064.003.0059","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0059","url":null,"abstract":"Rheumatoid arthritis (RA) is a progressive chronic systemic autoimmune disorder characterized by symmetric deforming erosive synovitis. Pulmonary involvement may occur in 18% of all patients with RA, is one of the most common extra-articular manifestations of the disease and is a major cause of morbidity and mortality. The most common pleuropulmonary manifestations of RA are rheumatoid-associated interstitial lung disease (RA-ILD), drug related lung disease, infection secondary to immunosuppression, necrobiotic nodules, organizing pneumonia, upper and lower airway disease, pulmonary vascular disease and serositis. A normal chest radiograph does not exclude RA-ILD. As disease progresses, radiographic abnormalities may become more apparent. Thin-section or high resolution computed tomography (HRCT) remains the study of choice to assess RA-ILD. Patients with RA-ILD have a slightly increased incidence of lung cancer, and radiologists must carefully scrutinize images looking for discrete nodules and masses.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125208246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0010
T. Ternes
{"title":"Thoracostomy Tubes and Mediastinal Drains","authors":"T. Ternes","doi":"10.1093/MED/9780199858064.003.0010","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0010","url":null,"abstract":"The Thoracostomy and Mediastinal Drains chapter addresses a group of medical devices used to drain intrathoracic collections of fluid or air. A chest (thoracostomy) tube is a broad term used for a variety of hollow catheters used for pleural drainage. Occasionally, the drain is placed in the mediastinum, and in these instances the term mediastinal drain is preferred. Thoracostomy tubes are typically placed in the pleural space for treatment of pneumothorax or pleural fluid. Tube sizes range from 6F to 40F, depending on the clinical scenario. Small catheters are often placed with Seldinger technique, whereas larger tubes are usually placed with blunt dissection. The tube is typically directed towards the apex in the setting of pneumothorax and towards the posterior base for treatment of pleural fluid collections. When interpreting radiographs following chest tube placement, the radiologist should ensure that the tube and sideport are positioned within the pleural space or the desired anatomic location. It is also imperative to exclude intraparenchymal or intrafissural tube placement and tube kinking.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"228 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114955592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0064
Felipe Martinez
{"title":"Amyloidosis","authors":"Felipe Martinez","doi":"10.1093/med/9780199858064.003.0064","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0064","url":null,"abstract":"Amyloidosis is a group of disorders characterized by over expression and extracellular deposition of amyloid with resultant organ dysfunction. The disease produces significant morbidity and mortality and its prevalence is increasing. Amyloidosis becomes clinically significant when organ function is impaired either due to loss of normal cell structure or mass effect from accumulating amyloid. The current classification of amyloidosis is based on the different types of fibrillar proteins which define organ involvement and disease manifestations. The heart is the most commonly involved organ in the chest, and progressive systolic dysfunction in a patient with ventricular hypertrophy is common. Pulmonary involvement is relatively rare and is more common in the localized form of the disease. There are systemic and localized forms of the disease, with systemic disease being more common. High resolution computed tomography (HRCT) is the modality of choice to evaluate patients with suspected tracheopulmonary amyloidosis. Cardiac MRI is the imaging modality of choice for evaluating patients with suspected amyloid cardiomyopathy.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116082798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0051
T. Ternes
{"title":"Pulmonary Metastases","authors":"T. Ternes","doi":"10.1093/med/9780199858064.003.0051","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0051","url":null,"abstract":"Pulmonary metastases represent spread of malignancy to the lung parenchyma. Patients with metastatic disease may present with dyspnea, cough, or hemoptysis. Alternatively, affected patients may be asymptomatic. The lungs are a common site for metastatic disease. Relatively common primary malignancies (breast, colon, lung, and kidney cancers) are the most common causes of pulmonary metastases. However, less common primary malignancies (choriocarcinoma, testicular cancers, melanoma, and sarcomas) have a higher likelihood to produce lung metastases. The vast majority of pulmonary metastases spread via the bloodstream. Hematogenous metastases are typically basilar predominant lung nodules. Metastatic nodules may be very small (miliary, < 3mm), or very large (cannonball), and may rarely be solitary. The presence of surrounding ground-glass attenuation (CT-Halo sign) often indicates surrounding hemorrhage. Some metastases may be cavitary or calcified. Pulmonary metastases may spread via the lymphatics. Asymmetric smooth or nodular interlobular septal thickening should raise concern for lymphangitic carcinomatosis. An uncommon mechanism is spread within the airways, which may result in an endobronchial lesion or post obstructive atelectasis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122398789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0060
Felipe Martinez
{"title":"Systemic Sclerosis","authors":"Felipe Martinez","doi":"10.1093/med/9780199858064.003.0060","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0060","url":null,"abstract":"Systemic sclerosis (SSc), or scleroderma is a chronic autoimmune disorder of small vessels and connective tissue characterized by organ fibrosis, small vessel vasculopathy and disease-specific antibodies. It results in multi system organ fibrosis. The skin, lungs, heart, gastrointestinal tract and kidneys are frequently affected. Skin involvement is typical. Clinically evident pulmonary disease is seen in 25% of affected patients, but autopsy reports demonstrate some degree of pulmonary involvement in all patients with the systemic form of the disease. Pulmonary disease is second only to esophageal fibrosis and has surpassed renal disease as the leading cause of death. Systemic sclerosis associated-interstitial lung disease (SSc-ILD) and pulmonary vascular disease are the two major lung manifestations of SSc. Pulmonary hypertension is the leading cause of death. A normal chest radiograph does not exclude SSc-ILD. High resolution CT (HRCT) should be part of the initial evaluation of patients with SSc, even when pulmonary symptoms are not present. The radiologist should be able to recognize signs of early pulmonary fibrosis and pulmonary hypertension on radiography and HRCT due to the proven benefit of adequate therapy in overall outcome and mortality.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122513806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0089
R. Benson
{"title":"Congenital Bronchial Atresia","authors":"R. Benson","doi":"10.1093/MED/9780199858064.003.0089","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0089","url":null,"abstract":"Congenital bronchial atresia (CBA) is a benign congenital abnormality in which there is focal atresia of a segmental bronchus with resultant distal endobronchial mucocele (bronchocele) and surrounding hyperlucent lung. Affected patients are typically young and asymptomatic, and the diagnosis is usually incidental. CBA is an imaging diagnosis that may be suspected on radiography but is usually confirmed on chest CT. The typical imaging appearance is a round, tubular or branching, non-enhancing mucocele with surrounding localized hyperlucent lung. Asymptomatic patients require no further imaging or treatment. However, surgical resection of the affected lung can be considered for symptomatic patients with recurrent pulmonary infections.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122483329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0074
J. Bueno
{"title":"Cystic Lung Disease","authors":"J. Bueno","doi":"10.1093/MED/9780199858064.003.0074","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0074","url":null,"abstract":"A lung cyst is a round parenchymal lucency or low-attenuating area with a well-defined interface with adjacent normal lung and surrounded by an epithelial or fibrous wall that is often less than 2 mm in thickness. Diseases that manifest with lung cysts comprise a limited but well known group of entities. Classic diseases manifesting with diffuse lung cysts include pulmonary Langerhans cell histiocytosis (PLCH), lymphangioleiomyomatosis (LAM), lymphocytic interstitial pneumonia (LIP) and Birt-Hogg-Dubé syndrome. However, it is important to recognize other conditions that may mimic cystic lung disease, such as pneumatoceles, tracheobronchial papillomatosis, cavitary disease (e.g. tuberculosis, fungal infection), bronchiectasis, and emphysema. Differentiation between true cysts and cyst mimics may be difficult, and may rely on identification of ancillary findings.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122144461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0011
B. Little
{"title":"Common Abnormalities on Portable Chest Radiography","authors":"B. Little","doi":"10.1093/MED/9780199858064.003.0011","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0011","url":null,"abstract":"Several acute pulmonary diseases are common in the inpatient setting including: Pneumonia, Aspiration, Pulmonary edema, Acute respiratory distress syndrome (ARDS), Atelectasis, and Pleural effusions or hemothorax. Appreciation of the clinical presentations and common imaging findings of these diseases is essential in interpreting bedside chest radiography. The chest radiograph is the most commonly performed radiographic examination, and bedside radiography plays an important role in assessing acute cardiopulmonary disease in the inpatient setting, particularly within intensive care units (ICUs). Radiologists must be aware of the range of abnormalities that manifest on bedside chest radiography in order to optimize patient care.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128271732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0072
S. Martinez-Jiménez
{"title":"Diffuse Infiltrative Lung Disease","authors":"S. Martinez-Jiménez","doi":"10.1093/MED/9780199858064.003.0072","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0072","url":null,"abstract":"Diffuse infiltrative lung disease refers to disorders with imaging abnormalities consisting of diffuse opacities that may manifest as reticular opacities, micronodules, hazy opacities or frank airspace disease. Diffuse infiltrative lung disease often refers to diffuse radiographic abnormalities that are optimally characterized on thin-section CT (e.g. interstitial lung disease such as UIP or NSIP). However, diffuse opacities on radiography may manifest with other findings on CT (e.g. cysts or emphysema). In addition, patients with diffuse infiltrative lung disease on CT may have normal radiographs (e.g. NSIP or pneumocystis pneumonia). The next chapters address pulmonary diseases manifesting with diffuse opacities on either chest radiography or CT, with an emphasis on the formulation of a narrow differential diagnosis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114351341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chest ImagingPub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0068
S. Bhalla
{"title":"Introduction to Iatrogenic Conditions","authors":"S. Bhalla","doi":"10.1093/MED/9780199858064.003.0068","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0068","url":null,"abstract":"Post-therapy imaging interpretation can be challenging. In most practices, the main thoracic interventions include drug therapy, surgery and radiation therapy. In certain practices, especially in the absence of stereotactic radiation, radiofrequency ablation and cryoablation have gained a foothold. Post -therapeutic changes in the lung may be divided into two main categories: local and diffuse. Local changes are usually seen with radiation and percutaneous therapies. Diffuse changes mainly include organizing pneumonia and alveolar damage. The latter may be seen after both medical and surgical intervention. Two key questions must be answered when dealing with the treated patient: what was the prior therapy and when was the treatment. Both questions will help determine the significance of the imaging findings.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114636191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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