Study Syllabus for Classification of Radiographs of Pneumoconioses

Radiograph Classification

Subset 2

Radiograph #20

Answer Key #20 (Updated 9/28/2023)

This radiograph is that of a coal miner. Initial evaluation shows small rounded opacities, and large opacities. Detailed analysis then proceeds through the following sequence of decisions.

Radiograph quality is graded 2 due to scapula overlay and mottle. The parenchymal opacities are consistent with pneumoconiosis, so Section 2A is checked “YES.”

The primary small opacity is rounded and estimated to be of the q size; that is, 1.5 to 3.0 mm in diameter. The secondary small opacity is of the r size; that is, 3 to 10 mm in size. All zones are involved. Comparison of the radiograph with the ILO Standards shows the closest match to be with the q/q – 2/2 Standard, although a match with q/q – 1/1 is also a consideration. Thus Section 2B is classified as follows: q/r, both upper and middle zone involvement with a profusion of 2/1.

In the right upper zones overlapping the first, second, and third anterior ribs are well-defined large opacities. These constitute a B large opacity; that is, the sum of the greatest dimensions of the large opacities is greater than 5 cm.

The costophrenic angles are not blunted, so the “NO” box is checked in 3C.

Other abnormalities are present, so in 4A the “YES” box is checked. The symbol di for distortion em for emphysema.

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