Anaesthesia | General ICU Care | Plain X-rays of the Adult Chest: Interstitial Lung Disease

Image Interpretation - Plain X-rays of the Adult Chest: Interstitial Lung Disease
Session Overview
Description
This session will look at the interstitial pattern of opacification which is commonly seen in chest radiographs. The anatomy and physiology of the lung interstitium will be presented. This will be correlated with the clinical and radiological features associated with common interstitial lung diseases, and other processes, which give rise to an interstitial pattern on chest radiograph.

Learning Objectives
By the end of this session you will be able to:

• Describe the lung interstitium's anatomy and basic physiological processes
• Differentiate between interstitial and airspace opacification in terms of pathophysiology and chest radiographic appearances
• List the common interstitial disease processes
• Use various radiological clues to improve the accuracy of your differential diagnosis

Prerequisites
Before commencing this session you should complete:

• Image Interpretation - Plain X-rays of the Adult Chest: Introduction
• Image Interpretation - Plain X-rays of the Adult Chest: General Anatomy and Physiology
• Image Interpretation - Plain X-rays of the Adult Chest: The Normal Chest Radiograph
• Image Interpretation - Plain X-rays of the Adult Chest: Airspace Opacification

The lung interstitium is the tissue surrounding the air sacs of the lung. Diseases which affect the lung interstitium may therefore have serious implications for effective respiration and oxygenation. It is therefore important to recognise signs of interstitial disease processes on chest radiographs if present.

This session gives a basic overview of the interstitial pattern seen in chest radiographs. To aid interpretation, the anatomy and physiology of the lung interstitium are discussed and related to common disease processes that cause interstitial shadowing.

Interstitial shadowing is differentiated from airspace opacification - the other major form of chest radiograph shadowing. Tips on how to differentiate between the most common interstitial disease processes are also presented. However, it should be recognised that whilst a chest radiograph will often tell you that a general interstitial pattern is present, it will not always be possible to be specific about a particular diagnosis. The gold standard for differentiating between interstitial disease processes is high-resolution computed tomography (HRCT).