CXR interpretation in TB patients

thus summerises the simplest way to read and interprete th CXR in tuberculosis patients

1. BASIC CXR IN MDR TB Pts Dr Peter D,D MDR TB expert Kibong’oto Infectious D’ses Hospital

2. Session objectives Participants should be able to Identify the CXR view and Asses quality of the image Asses various anatomical structures on the cxr image Identify lesions and their patterns Clinical significancy of CXR in MDR TB pts Draw conclusions from the findings and possible differential diagnosis

3. STANDARD CXR VIEWS IN TUBERCULOSIS A posterior-anterior (PA) chest X-ray is the standard view used ; AP in bed ridden pts Other views (lateral or lordotic ) or CT scans may be necessary.

4. FACTORS FOR QUALITY CXR Before interpreting a chest X-ray it is important to assess the quality of the image. Without this step you may diagnose disease that is not genuine or you may be wrongly reassured. This includes: Patient Identity(name, age, sex) Labeling/marker( R/L) Anatomical inclusion, projection, ( AP/ PA.Lat ) inspiration/lung volume, penetration (good/poor) and artifact

5. NORMAL CXR

6. POSSIBLE TB LESIONS ON CXR In active pulmonary TB, Infiltrates Consolidations or cavities are often seen in the upper zones with or without mediastinal/hilar lymphadenopathy mainly in immunocompetent patients

7. PATTERNS OF TB LESIONS ON CXR Tuberculosis is divided into two categories: Pulmonary Extrapulmonary. Pulmonary Tuberculosis includes Tuberculosis Pneumonia, Tuberculosis Pleurisy, Cavitary Tuberculosis, Miliary TB, and Laryngeal Tuberculosis

8. VARIOUS TUBERCULOUS LESIONS

9. TUBERCULOUS PATTERNS ctd

10. PEDIATRIC TB LESIONS

11. PEDIATRIC TB LESIONS ctd

12. CXR IN TB/HIV PATIENTS

13. MIMICS/ DDX OF TB ON CXR

14. POST TB COMPLICATIONS ON CXR(SEQUALAE)

15. CONCLUSION Quality CXR is key in image assessment Lesions on a CXR are many and overlaps in many diseases. Knowledge on clinical presentation, duration and risks associated with certain diseases increase suspicion index. Other complementing diagnostic aids should be reviewed to aid better reporting Multidisciplinary involvement via possible medias is encouraged to aid accurate diagnosis and hence management

16. References https://lifeinthefastlane.com/investigations/cxr-normal http://www.healthcommunities.com/tuberculosis/types.shtml Md.edu.Virginia university Radiographics