Critical reviews in diagnostic imaging
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Crit Rev Diagn Imaging · Jan 1984
ReviewRadiographic evaluation of asbestos-related chest disorders.
This paper reviews the radiographic, clinical, pathologic, and epidemiological features of pleural and pulmonary parenchymal disorders which have been related to asbestos exposure. In particular, the following are discussed: (1) pleural plaques--radiographic detection by plain films and computed tomography, normal and abnormal densities which may mimic plaques, the 1980 ILO U/C classification, recent epidemiological data on plaques including their relationship to carcinoma and mesothelioma; (2) diffuse pleural thickening; (3) benign asbestos pleural effusions; (4) mesothelioma--emphasizing recent advances in diagnosis, staging, therapy, and prognosis; (5) parenchymal fibrosis--pathogenesis, relationship to fiber exposure, plaques, and carcinoma; (6) bronchogenic carcinoma; (7) rounded atelectasis--recent observations on its association with pleural thickening. A role of radiology in medicolegal aspects of asbestos-related disease is briefly examined.
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Pneumomediastinum has numerous etiologies and its pathways of spread are multiple and well defined. Knowledge of these anatomic pathways and possible etiologies is important in order to avoid extensive and unnecessary evaluations. For example, if there is a known reason for pneumomediastinum, and pneumoperitoneum is present without associated abdominal findings, further evaluation for perforated viscus is unnecessary. ⋯ In critically ill infants and adults, pulmonary interstitial emphysema is an important warning sign for impending pneumothorax or pneumomediastinum and the patient's physicians should be alerted. There are occasional difficulties in differentiating pneumomediastinum from pneumopericardium and from a medial pneumothorax. Analysis of anatomic details and decubitus views are helpful in this regard.
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The lumbar facet joints have been recognized for many years to be an important source of chronic low back pain with sciatic radiation. The presence of unilateral chronic low back pain with sciatic radiation, but without objective neurological abnormality, is typical of symptomatic lumbar facet arthropathy. ⋯ The combination of computed tomography and fluoroscopically controlled intraarticular lumbar facet block is becoming an important examination sequence in the accurate diagnosis of symptomatic lumbar facet arthropathy. The development of concepts regarding lumbar facet joint abnormalities are reviewed, and implications of the development of new procedures for studying lumbar facet disease in the patient with chronic low back pain and sciatica are discussed.