Study Syllabus for Classification of Radiographs of Pneumoconioses
Subset 4 – Small and Large Opacities
Radiograph #41 – Type r
Small rounded opacities, type r
Radiograph #41A. This image presents no small parenchymal opacities, profusion 0/0.
Radiograph #41B. This radiograph is an example of r opacities, few in number in the upper lung zones, occurring with a profusion of 0/1. The presence of small opacities is rather subtle. As noted previously, technical limitations may lead to over-reading profusion category 0/1.
Radiograph #41C. Numerous rounded opacities are unequivocally present in the middle and upper zones of this image, however portions of the upper zones are less affected. Therefore when averaged overall the opacities are not numerous enough to be classified as 1/1. This radiograph represents a profusion of 1/0. The opacities in this radiograph are predominantly r opacities but with a few q opacities present as well.
Radiograph #41D is a good example of r opacities in the middle and upper zones and a profusion of 1/1. Note that the opacities in images #41B, #41C, and #41D differ slightly in size but that all fall within the defined limits (3-10 mm) for r opacities.The symbol ax should be checked to identify the coalescence seen under right clavicle first rib crossing.
Radiograph #42 – Type s
Small irregular opacities, type s
Radiograph #42A. This image presents no small parenchymal opacities, profusion 0/0. The hilar shadows, the vascular pattern, and the pleura are all normal.
Radiograph #42B. The few irregular opacities in this image are s irregular opacities predominately in the lower zones, right greater than left. Remember, s irregular opacities measure up to 1.5 mm in width. The vascular pattern here is largely intact. This radiograph presents a profusion level of 0/1.
Radiograph #42C presents slightly more irregular opacities in the lower zone than does Image #42B and therefore has a profusion of 1/0. The vascular pattern is perhaps a little less distinct, with more irregular opacities in the lateral lower zones. Low-profusion s opacities can be difficult to distinguish from normal vascular structures. Attenuation of blood vessels in the upper lobes suggests emphysema. Symbol em is checked.
Radiograph #42D. This image presents s irregular opacities in both middle and lower zones. There are some slightly thicker opacities of the t type. The vascular pattern is beginning to become less distinct, especially in the left lower zone and in the periphery of the right lower zone. This image should be classified as s/t 1/1. The obvious pleural disease should be classified, see answer sheet.