In the ever-evolving field of radiology, staying updated on infectious diseases and their radiological presentations is crucial. The 21st Monthly Case Webinar by Collective Minds Radiology, featuring Dr. Imran Lasker and special guest Dr. Elizabeth Joekes, provided valuable insights into this topic. As Dhaanish Parvez, Product Specialist at Collective Minds, I had the pleasure of introducing this enlightening session.
Dr. Elizabeth Joekes, co-founder of World Wide Radiology, emphasized the continued significance of chest X-rays in diagnosing infectious diseases, especially in resource-limited settings. As she aptly put it:
"Sometimes I think we sort of don't really think about how great chest x-rays are still are because we think about all these other you know super fancy modalities." 04:24
This statement underscores the importance of mastering chest X-ray interpretation, particularly when advanced imaging modalities are unavailable.
The webinar covered a range of cases, each highlighting different aspects of infectious diseases in radiology. Let's delve into some key takeaways:
Several cases demonstrated the varied presentations of tuberculosis (TB). One particularly striking example was a chest X-ray initially reported as normal but later revealed bilateral upper lobe abnormalities suggestive of TB. Dr. Joekes emphasized:
"When you see upper Zone abnormalities in a patient who's young enough enough that it's you know less likely to be cancer but possibly infective you might say okay right up a a bit of inflammatory change always make sure that it's not bilateral." 09:54
This case underscores the importance of thorough examination and considering TB in differential diagnoses, especially in high-risk populations.
Another case highlighted the characteristic "batwing" appearance of Pneumocystis pneumonia in an HIV-positive patient. This presentation, with perihilar opacities and sparing of the lung periphery, is a classic finding that radiologists should be familiar with, especially in regions with high HIV prevalence.
The webinar also touched on non-pulmonary infectious complications, such as rheumatic heart disease. Dr. Joekes presented a case of a 13-year-old child with mitral valve disease secondary to rheumatic fever, reminding us that:
"It's not uncommon to see it it's really half a million new cases each year still worldwide." 52:46
This case serves as a crucial reminder of the ongoing global health impact of rheumatic fever and the importance of recognizing its cardiac manifestations on chest X-rays.
Throughout the webinar, Dr. Joekes emphasized the challenges of diagnosing and managing infectious diseases in resource-limited settings. She shared valuable insights on making clinical decisions based on limited information:
"I had to really learn to come off the fence and just say okay you know given the the local situation the the epidemiology the prevalence that and what we can treat here." 56:39
This approach highlights the need for radiologists to adapt their practice to local contexts and available resources.
The Monthly Case Webinar #21, available as a case collection on Collective Minds, provided invaluable insights into the radiological presentation of infectious diseases. It emphasized the ongoing importance of chest X-rays, the need for a high index of suspicion for tuberculosis, and the challenges of practicing radiology in resource-limited settings.
As we continue to advance in the field of radiology, it's crucial to remember that basic imaging modalities like chest X-rays remain powerful diagnostic tools. By sharing knowledge and experiences across different healthcare settings, we can work towards improving global health outcomes.
What are your thoughts on the role of radiology in managing infectious diseases in resource-limited settings? How can we better prepare radiologists to work in diverse global health contexts?
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Reviewed by: Pär Kragsterman on September 21, 2024