Preliminary Diagnosis: Pulmonary Fibrosis
I. What imaging technique is first-line for this diagnosis?
Chest x-ray, PA, and lateral view.
II. Describe the advantages and disadvantages of this technique for diagnosing pulmonary fibrosis.
Advantages
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Highly portable.
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Relatively inexpensive and exposes patients to minimal ionizing radiation.
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Disadvantages
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Less sensitive and specific in detailing the underlying parenchyma and pleura or detecting and characterizing any secondary pulmonary complications compared to companion cross sectional CT imaging.
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Less adept in characterizing parenchymal architecture or specific abnormalities of the secondary pulmonary lobule.
III. What are the contraindications for the first-line imaging technique?
No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.
IV. What alternative imaging techniques are available?
CT/high resolution CT of the chest without contrast.
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing pulmonary fibrosis.
Advantages
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Highly sensitive and specific in detecting and characterizing any primary parenchymal or pleural abnormality and characterizing any secondary complication.
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Offers exquisite detail of the underlying lung architecture, with particular focus on the secondary pulmonary lobule.
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May help guide treatment.
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May help determine the chronicity of an interstitial pulmonary process.
Disadvantages
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Exposes patients to significantly more ionizing radiation than plain radiography.
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More expensive and less portable compared to plain radiography.
VI. What are the contraindications for the alternative imaging techniques?
May be contraindicated in pregnant patients.
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