Radiographic findings

Radiographic manifestations of diseases affecting the small airways are polymorphous. The chest radiograph can be often normal in patients with documented bronchiolitis, and its sensitivity to detect small airways disease is 

CT features Type of bronchiolitis Structures mainly involved 

Centrilobular nodules and branching lines (tree in bud) Cellular bronchiolitis Membranous and respiratory bronchioles 

Centrilobular nodules (with Cellular bronchiolitis Respiratory bronchioles 

Mixed pattern Cellular bronchiolitis Bronchiolitis with inflammatory polyps, cicatricial bronchiolitis Respiratory and membranous bronchioles 

---

Those with positive skin tests whose radiographic findings indicate non progressive, healed, or quiescent (causing no symptoms) tubercular lesions... 

Because bacteria do not represent primary pathogens in the etiology of bronchiolitis, antibiotics should not be routinely administered. However, many clinicians frequently administer antibiotics initially while awaiting culture results because the clinical and radiographic findings in bronchiolitis are often suggestive of a possible bacterial pneumonia. 

Radiographic findings include patchy or interstitial infiltrates, which are most commonly seen in the lower lobes. 

Radiographic findings are nonspecific and include bronchial wall thickening and perihilar and diffuse interstitial infiltrates. 

The pulmonary fibrotic changes develop slowly over the years, often progressively even without further exposure, and their radiographic detection is a direct correlate of their extent and profusion. In some cases minor fibrosis with considerable respiratory impairment and disability can be present without equivalent x-ray changes. Conversely, extensive radiographic findings may be present with little functional impairment. 

The answer is D. The patient s symptoms are consistent with a kidney stone, which is confirmed by the radiographic finding. The etiology of the stone is indicated by the urinalysis data, which suggest cystinuria. The cells of this patient s renal proximal tubules would be deficient in a transporter responsible for the reabsorptive uptake of cystine and the basic amino acids, arginine, lysine, and ornithine. Failure of the tubules to reabsorb these amino acids from the ultrafiltrate causes them to be excreted at high concentration in the urine. 

Amandus HE, Althouse R, Morgan WKC, et al. 1987. The morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite Part III. Radiographic findings. Am J Ind Med 11 27-37. 

An acute colitis, different from pseudomembranous colitis, was observed in five patients taking penicillin and penicillin derivatives (133). There was considerable rectal bleeding. The radiographic findings were those of ischemic colitis (spasm, transverse ridging, thumbprinting, and punctuate ulceration). On sigmoidoscopy and biopsy, the mucosa was normal, except for an inflammatory cell infiltration in one case. Conservative treatment resulted in rapid remission. 

Phenothiazines and metabolites have resulted in false positive results for tricyclic antidepressants using various screening methods. Unabsorbed phenothia-zine may be radiopaque on abdominal X-ray. Use caution, as the absence of radiographic findings does not rule out ingestion. 

Chest radiograph findings can help differentiate nonanthrax ILI from inhalational anthrax. In the October 2001 outbreak, all ten inhalational anthrax patients presented with abnormal chest radiographs. The radiographic findings were easier to discern with posteroanterior and lateral views, compared to portable anteroposterior views. In comparison, most cases of ILI are not associated with radiographic... 

Given its rarity, physicians and hospital laboratorians have a low index of suspicion for tularemia infection. Because of the nonspecific symptoms and absence of radiographic findings, physicians and public health authorities would have difficulty distinguishing between a terrorist attack involving tularemia and a natural outbreak of community acquired infection, especially influenza and some atypical pneumonias (43). Several epidemiologic clues that might indicate an intentional cause would include (43) ... 

Management of the patient with OA begins with a diagnosis based on a careful history, physical examination, radiographic findings, and an assessment of the extent of joint involvement. Treatment should be tailored to each individual. Goals are (1) to educate the patient, caregivers, and relatives (2) to reheve pain and stiffness (3) to maintain or improve joint mobility (4) to hmit functional impairment and (5) to maintain or improve quality of fife. ... 

Radiographic findings generally are more impressive than the patient s physical findings and include patchy or interstitial infiltrates, which are seen most commonly in the lower lobes. Small unilateral, transient pleural effusions are common, but large effusions and empyema are rare. Roentgenographic abnormalities resolve slowly, and 4 to 6 weeks may be required for complete resolution. 

All viral respiratory tract infections occur more commonly in the winter, and rapid person-to-person spread through susceptible populations is typical. Underlying cardiac or pulmonary disease predisposes to an increased incidence and severity of viral lower respiratory tract infection, especially with influenza virus in adults and RSV in children. Radiographic findings are nonspecific and include bronchial wall thickening and perihilar and diffuse interstitial infiltrates. Pleural effusions may be seen, especially in adenovirus and parainfluenza pneumonia. 

Patients coinfected with HIV may have atypical presentations. As their CD4-F counts decline, HIV-positive patients are less likely to have positive skin tests, cavitary lesions, or fever. Pulmonary radiographic findings may be minimal or absent. HIV-positive patients have a higher incidence of extrapulmonary TB and are more likely to present with progressive primary disease. Because their symptoms are not specific to TB, a thorough work-up for TB is essential. ... 

Winters WD, Weinberger E, Hatch El (1992) Atresia of the colon in neonates radiographic findings. AJR Am J Roentgenol 159 1273-1276... 

Esophageal perforation can be diagnosed on frontal and lateral chest radiographs. Findings include pneumomediastinum, pneumothorax, hydro-pneumothorax, subcutaneous emphysema and pleural effusions (Fig. 2.30). Chest radiography is not useful... 

Nunley WC, Pope TL, Bateman BG (1984) Upper reproductive tract radiographic findings in DES-exposed female offspring. AJR Am J Roentgenol 142 337-339... 

---