Skip directly to site content Skip directly to search


Español  Other Languages


Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People
 Search
		×
			NIOSH
			NIOSH
				All CDC
				Submit
			For a full list of topics:A-Z Index
			Advanced Search
		Advanced Search


The National Institute for Occupational Safety and Health (NIOSH)








Study Syllabus for Classification of Radiographs of Pneumoconioses						Print
																Related Pages
										Radiograph ClassificationSubset 2Radiograph #23
Answer Key #23
This case demonstrates pleural plaques and pleural effusion without small parenchymal opacities. In many instances, pleural abnormalities are the first radiographic evidence of asbestos exposure. Detailed analysis is as follows:
The technical quality of the radiograph is classified as 3 because of overexposure of the lungs, and “Overexposed (dark)” is checked. Other technical deficiencies include improper position (because the scapulae overlap the lungs) and exclusion of the left costophrenic angle, which is included on a second image. Artifacts, perhaps monitors, are also present.
There are no parenchymal abnormalities consistent with a pneumoconiosis, so “NO” is checked in Section 2A.
There are extensive pleural abnormalities bilaterally involving the chest wall and both costophrenic angles. Section 3A is therefore checked “**YES**.”
There are in-profile and face-on pleural plaques on the left lateral chest wall, so in 3B, “In profile” and “face on” are marked **L** for Site. Pleural calcifications are visualized in these plagues, so in profile and face on are marked **L** under Calcification as well. The left chest wall plaques are classified as follows: on the left, the maximum width of the plaque (the distance from the medial surface of the adjacent rib to the most medial and sharpest margin of the circumscribed plaque) measures more than 10 mm (width c). The combined length is between one-fourth and one-half of the projection of the lateral chest wall, classified as extent 2. (The face-on component produces a less sharply defined border overlying the third through fifth ribs anteriorly.) There is no right face-on or in-profile plaque, so **O** is marked under extent and width for the right side.
The right and left costophrenic angles are blunted either by thickened pleura or effusion. The left is seen on the second lower image of the chest, so Section 3C is checked **R and L**. Diffuse pleural thickening usually extends into and obliterates the entire costophrenic angle. This is the case on the right, however the left CP angle blunting is not continuous with the left chest wall in profile or face on process. Therefore this is not classified under diffuse pleural thickening. On the right the diffuse pleural thickening is seen both in profile and face on, and the findings are recorded in 3D as R for “Chest wall, Site.” There is no in-profile or face-on diffuse pleural thickening on the left. There is calcification of the diffuse pleural thickening on the right seen face on, so **R** is marked under Calcification for face-on plaque but not for in-profile plaque. The length does exceed one-fourth of the lateral chest wall but less than half, so it is classified as extent **2**, whereas the width is greater than 10 mm and is therefore classified **c**. There is no left diffuse pleural thickening, so **O** is marked under extent and width for diffuse pleural thickening on the left side.
Section 4A is checked “YES” to indicate that other abnormalities are present. These are indicated as follows: a pleural effusion may be present, so **ef** is checked; there may possibly be a mesothelioma on the right, so **me** is appropriately checked. (however, a mesothelioma usually produces an extensive pleural effusion and pleural nodularity, so the diagnosis is not likely in this case.) Notation should be made under 4C of the post-surgical changes of cardiac surgery and sternal wires. Since **me** was considered, the worker’s personal physician should be notified.RADIOGRAPH #22Page 4 of 6RADIOGRAPH #24
							
					
							Last Reviewed:  April 26, 2023						Source: 	National Institute for Occupational Safety and Health
					Facebook
        Twitter
        LinkedIn
        Syndicate homeStudy Syllabus for Classification of Radiographs of Pneumoconioses
Introductionplus icon
Preface
Appreciation to Contributors
Intent of the Self-study Syllbus
Getting Started
Clinical Overviewplus icon
Major Occupational Lung Diseasesplus icon
Pneumoconioses
Central Role of Diagnostic Imagingplus icon
Role of CT
Overview of Nonimaging Clinical Tools in Lung Disease Diagnosis
Appendix A
References
Pathology Overviewplus icon
Pulmonary Silicosis
Coal Workers’ Pneumoconiosis
Asbestos Pleuropulmonary Disease
Pathological-Clinical Correlations
References
Radiograph Classificationplus icon
SUBSET 1 – Radiograph Classification, #1 to #19plus icon
Introduction
Radiograph Identification
Section 1: Image Quality
Section 2: Parenchymal Abnormalities, #1 to #14
Section 3: Pleural Abnormalities, #15 to #19
Section 4: Any Other Abnormalities
Section 5
SUBSET 2 – Radiograph #20 to #27plus icon
Radiograph #20
Radiograph #21
Radiograph #22
Radiograph #23
Radiograph #24
Radiographs #25 to #27
SUBSET 3 – Radiograph #28 to #38plus icon
Radiographs #28 to #30
Radiographs #31 to #32
Radiographs #33 to #35
Radiographs #36 to #38
SUBSET 4 – Radiograph #39 to #46 (Small and Large Opacities)plus icon
Radiographs #39 to #40
Radiographs #41 to #42
Radiographs #43 to #44
Radiograph #45
Radiograph #46
SUBSET 5 – Classifications and Answer Keys, Radiographs #47 to #83
Quiz Follow NIOSH Facebook
Pinterest
Twitter
YouTube
 NIOSH Homepage NIOSH A-Z
Workplace Safety & Health Topics
Publications and Products
Programs
Contact NIOSH


About CDC
					Contact Us
					800-232-4636
 Facebook Twitter Instagram LinkedIn Youtube Pinterest Snapchat
 CONTACT CDC
				Contact Us
							Call 800-232-4636
							Email Us
			ABOUT CDC
				About CDC
							Jobs
							Funding
			POLICIES
				Accessibility
							External Links
							Privacy
							Policies
							No Fear Act
							FOIA
							OIG
							Nondiscrimination
							Vulnerability Disclosure Policy
			CONNECT WITH US
				Facebook
								Twitter
								Instagram
								LinkedIn
							Youtube
								Pinterest
								Snapchat
								Email
			LANGUAGES
				Español
							繁體中文
							Tiếng Việt
							한국어
							Tagalog
							Русский
							العربية
							Kreyòl Ayisyen
							Français
							Polski
							Português
							Italiano
							Deutsch
							日本語
							فارسی
							English


U.S. Department of Health & Human Services
			Accessibility
			External Links
			Privacy
			Policies
			No Fear Act
			FOIA
			Nondiscrimination
			OIG
			Vulnerability Disclosure Policy
			USA.gov


Exit Notification / Disclaimer Policy Close
 Links with this icon  indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
				Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
				You will be subject to the destination website's privacy policy when you follow the link.
				CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Website Disclaimers
 Cancel Continue