Slide 1: Your patient presents with a dry cough, fever and dyspnea. A portable CXR is shown below. What are the findings? Are they compatible with COVID19 infection?
Slide 2: There is patchy bibasilar consolidation (dotted lines), a non-specific finding that could be due to multiple causes including bacterial pneumonia, aspiration, etc. But in this case, it was COVID19 infection. Initial CXRs in COVID19 patients are often normal. What are the current American College of Radiology recommendations regarding imaging of COVID19?
Slide 3: 1. Facilities may consider deploying portable radiography units in ambulatory care facilities for use when CXRs are considered medically necessary. The surfaces of these machines can be easily cleaned, avoiding th need to bring patients in to radiography rooms. 2. CT should not be used to screen for or as a first-line test to diagnose COVID-19.
Slide 4: Unfortunately, there are no specific COVID19 findings; in fact, early scans may be normal, but some features have ben described as characteristic. After 3-5 days: peripheral, round basilar and bilateral ground glass opacity with/without consolidation. After 6 days: peripheral and basilar consolidation. Question 4: Spaced repetition: what is the difference between GGO and consolidation?
Slide 5: Ground glass opacity is denser (whiter) than normal lung, but as compared to consolidation, not dense enough to obscure vessels within the area of GGO.