Radiography case studies

The first two case studies are patients who might be seen by a physiotherapist, although other health care professionals might see similar patients for different reasons. The third situation is where a radiographer might administer or prescribe drugs to counteract the effects of therapeutic radiography. 

When puberty is delayed in a girl, measurement of serum gonadotropins is useful for diagnostic purposes. Low concentrations may indicate pituitary failure, whereas concentrations elevated mto the postmenopausal interval mdicate definite gonadal failure. In the latter case, chromosome studies are indicated. In the former case, pituitary function testing and radiography may be helpful. Patients... 

The prevalence of ILD in SjS depends on the methods used for detection. In historical series primary and secondary SjS were pooled (193-199). Lung involvement is usually subclinical. In the largest prospective study, containing 100 patients with primary SjS, about 5% had abnormal radiography, and a reduction in FVC and DLco was found at presentation in 12% and 10%, respectively (197). BAL yields an alveolitis in about half of cases without clinical manifestations (147,200). HRCT reveals abnormalities in a third of unselected patients with primary SjS (201) and in up to 89% of patients with respiratory symptoms (202), but significant pulmonary fibrosis in only approximately 20% (201,202). Over two-thirds of dyspneic patients with primary SjS have interstitial abnormalities on transbronchial biopsy (203). 

ILD occurs in approximately 40% of cases with a wide reported range of 5% to 65% (26,227-229,231-235). In a recent prospective study, of newly diagnosed PM/DM, pulmonary symptoms were present in 71% of patients and objective evidence of OLD (as judged by chest radiography, HRCT, or a restrictive ventilatory defect) was found in 65%, with 18% clinically silent (231). Adult patients with PM and DM are equally predisposed to develop ILD, but ELD is very frequent in Asian patients with CADM (26). ILD is extremely rare in inclusion-body myositis. 

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