Preliminary Diagnosis: Idiopathic Pulmonary Fibrosis
I. What imaging technique is first-line for this diagnosis
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Chest x-ray, PA and lateral view
II. Describe the advantages and disadvantages of this technique for diagnosis
Advantages
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Highly portable and relatively inexpensive imaging modality
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Exposes patients to minimal ionizing radiation
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Disadvantages
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Less sensitive and specific in diagnosing a primary parenchymal and/or pleural abnormality or detecting any secondary complications compared to cross-sectional imaging
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Unable to evaluate the secondary pulmonary lobule, which would be helpful in generating a differential diagnosis
III. What are the contraindications for the first-line imaging technique?
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No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.
IV. What alternative imaging techniques are available?
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CT of the chest without contrast/high resolution CT of the chest
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis
CT of the chest without contrast/high resolution CT of the chest
Advantages
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The gold standard in evaluating and characterizing idiopathic pulmonary fibrosis
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Highly sensitive and specific in evaluating for a primary parenchymal and/or pleural abnormality, and detailing and characterizing a secondary complication
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Offers exquisite visualization and evaluation of the secondary pulmonary lobule and interlobular and intralobular septae.
Disadvantages
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Exposes patients to ionizing radiation
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More expensive compared to plain radiography
VI. What are the contraindications for the alternative imaging techniques?
CT of the chest without contrast/high resolution CT of the chest
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CT imaging may be contraindicated in pregnant patients.
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