*** In Progress ***
Brandon Fainstad, MD
- Describe common radiographic features of various interstitial lung disease
- Identify distinguishing characteristics of the most common and reversible etiologies of interstitial lung disease
65 year-old-man presents to the ED with progressive shortness of breath and dry cough over the past 5 years that has accelerated in recent weeks to the point that he can no longer ambulate. He denies fevers, chills, chest pain, weight changes, joint pain or skin changes. Past medical history is notable for atherosclerotic disease with coronary and carotid stents placed 15 years ago, obesity, hypertension and OSA. Only medications are aspirin and a statin. He has a 90 year tobacco pack year, quit 15 years ago. He is afebrile, HR 110bpm, BP 140/80 with SpO2 74% on room air, improved to 93% after 5 minutes on 100% non-rebreather.
Exam notable for increased work of breathing and diffuse lung crackles.
|Portable CXR||CT axial||CT coronal|
What additional history and work-up do you want at this point?
What is your leading diagnosis?
Apical vs. basilar
Central vs. Pleural Based vs.
Sub-Pleural Sparing – e.g. NSIP
Focal vs. diffuse vs. isolated diffuse
Descriptors / Buzz words
Ground Glass Opacities – e.g. Amioderone toxicity
Honeycombing – e.g. UIP / IPF
|Signet Ring||Tram Tracking||Traction Bronchiectasis|
Density – well vs. poorly defined
|Consolidation – e.g. COP||Nodule||Mass|
|Perilymphyatic – subpleural, fissures, intralobular septa (e.g. lymphangitis carcionomatosis)||Centrilobular – along airways, spare periphery (e.g. tuberculosis, pneumoconioses||Random|