Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
On HRCT there are ... reticular, nodular ... low attenuation (table ... is reticular. ... Diagnosis #Radiology #Pulmonary
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
bronchiolitis (RB-ILD ... - Aspiration - Pulmonary ... Diagnosis #Radiology #Pulmonary ... #HRCT #ChestCT ... #Differential #Table
Perilymphatic distribution
Perilymphatic nodules are most commonly seen in sarcoidosis.
They also occur in silicosis, coal-worker's pneumoconiosis and
thickening in the reticular ... pattern. ... Diagnosis #Radiology #Pulmonary ... #HRCT #CTChest
Here are the most common examples of these four patterns on a chest x-ray (click image
of these four patterns ... consolidation - Multifocal ill-defined ... Interstitial - Reticular ... mass - Solitary Pulmonary ... Consolidation #Patterns
Nodular pattern
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary TB: random nodules
3. Sarcoidosis: nodules with perilymphatic
Nodular pattern ... Hypersensitivity pneumonitis: ill ... Clinical #Radiology #HRCT ... CTChest #Nodular #Pattern ... #Comparison #Table
Reticular pattern 
1. Lymphangitic carcinomatosis: irregular septal thickening, usually focal or unilateral 50% adenopathy', known carcinoma.
2.
Reticular pattern ... Cardiogenic pulmonary ... incidental finding in HRCT ... #CTChest #Reticular ... #Table #RadiologyAssistant
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
the dominant HR-pattern ... : reticular nodular ... Diagnosis #Radiology #Pulmonary ... Interpretation #Algorithm ... #ILD #RadiologyAssistant
UIP
UIP is a histologic pattern of pulmonary fibrosis.
On a chest X-ray UIP manifests as a reticular
of pulmonary fibrosis ... manifests as a reticular ... A HRCT is needed ... Here a CXR with a reticular ... HRCT demonstrated
Algorithm for nodular pattern
The algorithm to distinguish perilymphatic, random and centrilobular nodules is the following:
- Look
Algorithm for nodular ... pattern The algorithm ... are visible, the pattern ... Diagnosis #Radiology #Pulmonary ... #HRCT #CTChest
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
listed in the table ... have specific patterns ... morphologic findings on HRCT ... Diagnosis #Radiology #Pulmonary ... IdiopathicInterstitialPneumonia #ILD