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DR Khanyakude S MASHAO MBCHB,MMED RAD(D),DOH RADIOLOGIST MBOD.

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Presentation on theme: "DR Khanyakude S MASHAO MBCHB,MMED RAD(D),DOH RADIOLOGIST MBOD."— Presentation transcript:

1 DR Khanyakude S MASHAO MBCHB,MMED RAD(D),DOH RADIOLOGIST MBOD

2  Good quality radiographs are essential for accurate diagnosis and classification of occupational lung diseases  A reader is expected to grade film quality.  Grade1 :Good  Grade 2 :Acceptable with to technical defects to impair classification.  Grade 3: Acceptable with technical defects but still adequate  Grade 4 Unacceptable with quality defects

3 Quality defects include  Under-inflation  Improper position  Artifacts  Over-exposure  Film processing/post processing in case of digital  Under-exposure

4 Small opacities: small opacities are classified according to shape and size Small rounded opacities  P up to 1.5 mm  Q about1,5 mm to 3mm  R exceeding 3mm Small irregular opacities  Small irregular opacities are classified by width as s, t or u( same respective sizes as for small rounded opacities

5  Lung zones: each lung is divided into upper,middle and lower zones  Profusion: The concentration of small opacities are classified on the 4 point major category( 0,1,2 or 3.  With each major category divided into 3 giving order sub categories of increasing profusion(0,0/1,1/0,1/1,1/2,2/1,2/2,2/3, 3/2,3/3 and 3/+

6  Category 3 represents most profuse  The major category(first number) represents the profusion best fit the film.  The minor category(second number) represents the profusion seriously considered as an alternative  Category 0 refers to absence of small opacities

7  LARGE OPACITIES:A large opacity is defined as any opacity greater than 1cm  Category A:One or more large opacities whose combined dimension does not exceed 50 mm  Category B: :One or more large opacities with a combine dimension that exceed 50mm but does not exceed the equivalent area of the right upper lobe.  Category: exceeds the equivalent area of the right upper lobe.

8 Pleural abnormalities are reported with respect to the type  Pleural plaques or diffuse thickening  Location: chest wall, diaphragm  Presence of calcification  Width: only of in profile pleural thickening seen along the chest wall edge  Extent: combined distance for involved chest wall

9  There are about 29 symbols representing important features related to dust diseases and other etiologies e.g. : tba: active TB, em: emphysema,es: eggshell, hi : hilar- adeno-pathy, ef: effusion. Finally the reader comments on any other abnormal feature in the chest radiograph

10  The differential diagnosis of a diffuse reticulonodular infiltrate:  Pneumocystis carinni  Miliary tuberculosis  Lymphocytic interstitial pneumonia  Kaposi’s sarcoma  Sarcoidosis  Toxoplasma gondii  Cytomegalovirus  * Thus needs investigation

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