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Chest Film Search Pattern

David S. Feigin, M.D.

PRELIMINARIES

  • Verify patient information and date on both films and position of LEFT or RIGHT marker on frontal.
  • Note adequacy of penetration and any technical defects.
  • Look briefly at the entirety of both films for obvious abnormalities.

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Systematic Approach to Abnormal Chest Films

David S. Feigin, M.D.

I. DEFINITIONS

  1. Pattern: abnormalities of the lungs as seen on images
  2. Disease: causes of patterns as seen on specimens
  3. Diffuse pulmonary disease: nonspecific term for pulmonary disease involving all or most of the lungs and producing any pattern of abnormalities on chest films and CT.
  4. Infiltrative lung disease: nonspecific term for any restrictive pulmonary disease which infiltrates rather than destroys lung parenchyma.
  5. Nodule: often used to mean “small mass” – therefore, same causes as Mass (if number is countable)
  6. Interstitial lung disease: pathology term for thickening or destruction of pulmonary interstitium, which includes alveolar walls, septa and connective tissue surrounding bronchi and vessels (peribronchial and perivascular spaces). Correlates with functional term “restrictive lung disease” and with interstitial pattern on chest films.
  7. Consolidative Pattern: preferred over ‘alveolar pattern’ to describe the radiological pattern of filled air spaces
  8. Consolidative Pattern: “Large airways” (Bronchi) have visible walls on plain films when they are abnormally thickened. “Small airways” (mostly Bronchioles) have walls too small to be visible, even when thickened.