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Geriatric chest imaging: when and how to image the elderly lung, age-related changes, and common pathologies.

Gossner J, Nau R - Radiol Res Pract (2013)

Bottom Line: Even in a global perspective, societies are getting older.It is especially important to separate the process of ageing from the disease itself.Pathologies with a special relevance for the elderly patient are discussed in detail: pneumonia, aspiration pneumonia, congestive heart failure, chronic obstructive pulmonary disease, the problem of overlapping heart failure and chronic obstructive pulmonary disease, pulmonary drug toxicity, incidental pulmonary embolism pulmonary nodules, and thoracic trauma.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Radiology, Göttingen-Weende Hospital, An der Lutter 24, 37074 Göttingen, Germany.

ABSTRACT
Even in a global perspective, societies are getting older. We think that diagnostic lung imaging of older patients requires special knowledge. Imaging strategies have to be adjusted to the needs of frail patients, for example, immobility, impossibility for long breath holds, renal insufficiency, or poor peripheral venous access. Beside conventional radiography, modern multislice computed tomography is the method of choice in lung imaging. It is especially important to separate the process of ageing from the disease itself. Pathologies with a special relevance for the elderly patient are discussed in detail: pneumonia, aspiration pneumonia, congestive heart failure, chronic obstructive pulmonary disease, the problem of overlapping heart failure and chronic obstructive pulmonary disease, pulmonary drug toxicity, incidental pulmonary embolism pulmonary nodules, and thoracic trauma.

No MeSH data available.


Related in: MedlinePlus

Drug induces lung changes with the use of amiodarone in an 81-year-old patient. Computed tomography shows the pattern of cryptogenic organizing pneumonia.
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fig7: Drug induces lung changes with the use of amiodarone in an 81-year-old patient. Computed tomography shows the pattern of cryptogenic organizing pneumonia.

Mentions: Pulmonary drug toxicity has recently received increased attention. Once believed to occur only with a few drugs, the list of causative agents is steadily growing. In a 2001 review, already about 150 causative drugs were mentioned and even more can be found in an internet database (PneumoTox) [38, 39]. The incidence is unclear, because systematic studies are lacking [40]. Age is not a risk factor per se, but as an effect of their multimorbidity, elderly people often take a variety of drugs. So, they are exposed to a wider range of possible causative agents and drug interactions (e.g., degradation via similar enzymatic mechanisms) which may cause an enhanced pulmonary toxicity [40]. If pulmonary drug toxicity is suggested or is a potential differential diagnosis, imaging with high resolution chest CT should be performed because of its superior sensitivity over plain radiography [41]. On imaging, common forms of toxic changes are fibrosing alveolitis (with a pattern often resembling findings in nonspecific interstitial pneumonia), predominantly subpleural consolidations (resembling cryptogenic organizing pneumonia or eosinophilic pneumonia), and in the more acute setting hypersensitivity reactions with imaging findings ranging from ground glass opacities and alveolar consolidations to severe diffuse alveolar damage indistinguishable from ARDS [38, 40] (Figure 7).


Geriatric chest imaging: when and how to image the elderly lung, age-related changes, and common pathologies.

Gossner J, Nau R - Radiol Res Pract (2013)

Drug induces lung changes with the use of amiodarone in an 81-year-old patient. Computed tomography shows the pattern of cryptogenic organizing pneumonia.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713368&req=5

fig7: Drug induces lung changes with the use of amiodarone in an 81-year-old patient. Computed tomography shows the pattern of cryptogenic organizing pneumonia.
Mentions: Pulmonary drug toxicity has recently received increased attention. Once believed to occur only with a few drugs, the list of causative agents is steadily growing. In a 2001 review, already about 150 causative drugs were mentioned and even more can be found in an internet database (PneumoTox) [38, 39]. The incidence is unclear, because systematic studies are lacking [40]. Age is not a risk factor per se, but as an effect of their multimorbidity, elderly people often take a variety of drugs. So, they are exposed to a wider range of possible causative agents and drug interactions (e.g., degradation via similar enzymatic mechanisms) which may cause an enhanced pulmonary toxicity [40]. If pulmonary drug toxicity is suggested or is a potential differential diagnosis, imaging with high resolution chest CT should be performed because of its superior sensitivity over plain radiography [41]. On imaging, common forms of toxic changes are fibrosing alveolitis (with a pattern often resembling findings in nonspecific interstitial pneumonia), predominantly subpleural consolidations (resembling cryptogenic organizing pneumonia or eosinophilic pneumonia), and in the more acute setting hypersensitivity reactions with imaging findings ranging from ground glass opacities and alveolar consolidations to severe diffuse alveolar damage indistinguishable from ARDS [38, 40] (Figure 7).

Bottom Line: Even in a global perspective, societies are getting older.It is especially important to separate the process of ageing from the disease itself.Pathologies with a special relevance for the elderly patient are discussed in detail: pneumonia, aspiration pneumonia, congestive heart failure, chronic obstructive pulmonary disease, the problem of overlapping heart failure and chronic obstructive pulmonary disease, pulmonary drug toxicity, incidental pulmonary embolism pulmonary nodules, and thoracic trauma.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Radiology, Göttingen-Weende Hospital, An der Lutter 24, 37074 Göttingen, Germany.

ABSTRACT
Even in a global perspective, societies are getting older. We think that diagnostic lung imaging of older patients requires special knowledge. Imaging strategies have to be adjusted to the needs of frail patients, for example, immobility, impossibility for long breath holds, renal insufficiency, or poor peripheral venous access. Beside conventional radiography, modern multislice computed tomography is the method of choice in lung imaging. It is especially important to separate the process of ageing from the disease itself. Pathologies with a special relevance for the elderly patient are discussed in detail: pneumonia, aspiration pneumonia, congestive heart failure, chronic obstructive pulmonary disease, the problem of overlapping heart failure and chronic obstructive pulmonary disease, pulmonary drug toxicity, incidental pulmonary embolism pulmonary nodules, and thoracic trauma.

No MeSH data available.


Related in: MedlinePlus