On the basis of limited benefit in relation to cost, mass radiographic screening for tuberculosis was challenged and abandoned in the 1970s. In the 1980s the value of such periodic screening of hospital employees with known positive tuberculin reactions was queried on the same grounds but without comparable data. We report here the results of 11 years of radiographic screening of tuberculin-positive employees of a university hospital. Although 3900 chest films were obtained at considerable cost, only one proved and six suspect cases of tuberculosis were detected, all of which were symptomatic. Even in the absence of symptoms all could have been identified by other screening criteria, five on the basis of recent tuberculin conversion and two as tuberculin-positive new employees. These data support the recent statement that periodic chest roentgenograms of hospital employees with known positive reactions to tuberculin skin testing are not justified.

Adult↗

PubMed1984

Pneumonitis after amiodarone therapy.

Amiodarone (Cordarone) is an antiarrhythmic cardiac drug that is currently being evaluated in the United States. Pulmonary infiltrates developed in six of 34 patients who were receiving amiodarone in daily doses of 200-800 mg over a period of 1.5 to 12 months. Two patients died, one returned to normal after amiodarone had been discontinued for six months, and three have residual radiographic abnormalities (two continue to receive amiodarone with steroids). Radiologists should be aware of the history of amiodarone therapy and this possible serious side effect so that they can detect the earliest changes in the lung.

Aged↗

PubMed1982

Nonchanging mammograms in proven carcinoma of the breast: additional cases wanted.

Explore the source record for details and available documents.

Aged↗

PubMed1981

Clinical and radiographic manifestations of aortoesophageal fistulas.

Aneurysms of the thoracic aorta simulated primary esophageal disease both clinically and radiographically in 5 patients. Four had an aortoesophageal fistula at the time of presentation; endoscopic biopsy of a presumed esophageal tumor precipitated hematemesis in the fifth patient. In retrospect, the fistulas were demonstrated by barium esophagography in 3 patients. In 3, arteriography showed the aortic aneurysm but failed to reveal the fistula. The literature confirms a similar presentation for most other aortoesophageal fistulas, with premonitory esophageal bleeding followed hours to days later by massive hemorrhage. Of the reported cases of rupture of aneurysms of the thoracic aorta, 12% bled into the esophagus. While clinical and radiographic distinction between primary esophageal disease and esophageal manifestations of an aortic aneurysm is occasionally difficult, it is crucial for proper management.

Aged↗

PubMed1981

Radiologic errors in patients with lung cancer.

Some 20 percent to 50 percent of detectable malignant lesions are missed or misdiagnosed at the time of their first radiologic appearance. These errors can result in delayed diagnosis and treatment, which may affect a patient's survival. Use of moderately high (130 to 150) kilovolt peak films, awareness of portions of the lung where lesions are often missed (such as lung apices and paramediastinal and hilar areas), careful comparison of current roentgenograms with those taken previously and the use of an independent second observer can help to minimize the rate of radiologic diagnostic errors in patients with lung cancer.

Diagnostic Errors↗

PubMed1979

The lateral radiograph for early diagnosis of lung cancer.

The authors reviewed lateral radiographs to analyze the first findings in lung cancer in three groups of patients: those with proved lung cancer (78 patients); those with lung cancer initially undetected (27 patients); and those who had chest radiographs for any reason (10,597 patients). In no instance was a lesion detected on the lateral view only.

Humans↗

PubMed1978

Percutaneous transthoracic aspiration needle biopsy.

An experience based on 1,211 patients has shown aspiration needle biopsy to be a valuable technique for diagnosing bronchogenic carcinoma and other localized intrathoracic lesions that are beyond the reach of the fiberoptic bronchoscope. In 896 patients with malignant intrathoracic neoplasm, the aspirate demonstrated malignant cells in 96%. A false cytological diagnosis of carcinoma occured in 2 patients, for a true positive rate of 99%. However, the true negative rate was only 87%. In 77% of 31 immunosuppressed patients, the causative agent of a focal infectious process was diagnosed. Pneumothorax was the only notable complication, occuring in 24% of patients, with 14% requiring chest tube drainage. The procedure is relatively simple and rapid, generally causes little patient discomfort, and can be performed in virtually any hospital.

Adolescent↗

PubMed1978

Vigorous intrathoracic needle aspiration biopsy: a micropathologic technic.

Modification of intrathoracic needle aspiration using a vigorous technic consisting of multiple short, plunging, and rotating movements of the needle tip allows retrieval of a micropathologic rather than a cytologic specimen. This often facilitates more specific diagnosis and allows pathologists not expert in cytology to interpret the results. Increased incidence of transient hemoptysis is the only penalty incurred by this technic. The high diagnostic accuracy and clinical value of this simple short procedure in 31 patients is emphasized.

Biopsy, Needle↗

PubMed1978

Transverse colon in adult umbilical hernia.

The transverse colon may extend into an umbilical or other ventral hernia. An unusual configuration, extra anterior loops, outpouchings, narrowing, or nonmalignant-appearing obstruction in the involved segment of the colon should suggest possible herniation. Clinical or radiographic confirmation is easily accomplished. Five cases are presented to illustrate some of the deformities of the transverse colon due to involvement in an umbilical hernia.

Aged↗

PubMed1978

Chest film before laryngography.

Explore the source record for details and available documents.

Diagnosis, Differential↗

PubMed1976

Roentgenographic recognition of bronchoceles.

Bronchoceles often have characteristic plain film, tomographic, and bronchographic appearances, and they may trap air. Roentgenographic recognition of bronchoceles can allow them to be distinguished from neoplasms and sometimes help avoid unnecessary surgery.

Adolescent↗

PubMed1976

Axillary lymphadenopathy simulating an anterior mediastinal mass on the lateral chest roentgenogram.

The radiographic impression of an anterior mediastinal mass on the lateral chest roentgenogram must be confirmed by the postero-anterior film, oblique views, or tomograms to avoid inappropriate diagnostic procedures or erroneous staging of malignant disease. Physical examination will readily demonstrate enlarged axillary lymph nodes mimicking an anterior mediastinal mass.

Diagnosis, Differential↗