Taryn Reddy - Academia.edu (original) (raw)

Papers by Taryn Reddy

PubMed, Sep 1, 2023

INTRODUCTION: Dermatomyositis (DM) is part of a rare spectrum of inflammatory myopathies with sys... more INTRODUCTION: Dermatomyositis (DM) is part of a rare spectrum of inflammatory myopathies with systemic manifestations including cutaneous, skeletal muscle, and internal organs. Pulmonary involvement includes respiratory muscle weakness, aspiration pneumonia, and interstitial lung disease (ILD). We present the case of rapidly progressive ILD due to DM. CASE PRESENTATION: A 42 year old Hispanic female with no prior medical history presented to the ED with a chief complaint of shortness of breath for 4 weeks. Patient stated she had been experiencing a red rash on her face, chest, and fingers for the past 3 months. In the last month she displayed progressive extremity weakness, intermittent wheezing, and facial swelling. CK was elevated at 6661 u/l. Quadriceps biopsy confirmed the diagnosis of DM. Patient was treated with IVIG, pulse steroids, and cyclophosphamide. Patient was transferred to MICU on hospital day 9 due to hypoxia. Patient required an embolization due to an expanding rectus sheath hematoma and couldn't be extubated. Hypoxia worsened despite maximal vent support on CMV, a trial of APRV, paralytics, and inhaled nitric oxide. On hospital day 15 patient was started on VV-ECMO. Despite prolonged aggressive support patient lacked improvement. Patient was made comfort measures by family and pronounced on hospital day 22. DISCUSSION: ILD occurs with DM in up to 35-45% of cases; with a mortality approaching 50% when rapidly progressive. This latter form is more common among patients with amyopathic DM, making this case more atypical. Radiologic and pathologic findings are variable. Ground-glass opacities on CT are associated with fatal ILD in DM. Therapies for DM with ILD have been difficult to research due to disease rarity. Steroids are frontline therapy, however response is variable. The need for additional therapy is common, particularly in rapidly progressive ILD. Reports exist of patients improving with tacrolimus, mycophenolate mofetil, rituximab, and IVIG. Cyclophosphamide can be beneficial but is reserved for severe cases due to its toxicity. CONCLUSIONS: DM is a rare disease that is commonly complicated by ILD. Prompt recognition and treatment is vital to prevent catastrophic decompensation, particularly in rapidly progressive cases.

Radiology Case Reports, Oct 1, 2023

Journal of Thoracic Imaging, Sep 1, 2012

Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonar... more Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonary ossification distributed in a characteristic branching pattern. It is usually associated with chronic interstitial inflammation and fibrosis but may occasionally be idiopathic. The underlying pathogenesis remains uncertain. Computed tomography findings characteristically show fine branching heterotopic bone formation within the lungs, often in a lower lobe distribution. A case of idiopathic dendriform ossification is described in a 34-year-old man who presented for investigation of hemoptysis.

Internal Medicine Journal, Jul 1, 2019

Background: We report the prevalence and progression of incidentally detected interstitial lung a... more Background: We report the prevalence and progression of incidentally detected interstitial lung abnormalities (ILA) in the Queensland Lung Cancer Screening Study cohort. Methods: About 256 volunteers aged 60-74, with ≥30 pack years smoking history and forced expiratory volume in 1 s (FEV1) ≥50% predicted underwent low-dose computed tomography (CT) chest screening. Electronic search of baseline (T0) and 2-year followup (T2) CT reports identified candidate cases using Fleischner Society interstitial terminology. Candidate CT were reviewed in a randomised order by two experienced radiologists and a senior respiratory medicine trainee blinded to the existing reports. Scans were evaluated for the presence and extent of ILA using an in-house score, and graded for progression. Results: ILA were detected in 20/256 baseline cases (7.8%) with no incident cases detected at T2 surveillance imaging. Of these 20 cases, 9 (45%) had reticulation, 18 (90%) had ground glass change, 1 had traction bronchiectasis and 1 had randomly distributed nodularity. Seven cases with ground glass changes also had areas of reticulation, and only two had reticulation alone. All ILA were graded as minor except for traction bronchiectasis, which was moderate. Only one case progressed on T2 imaging. ILA were associated with the presence of auscultatory crackles (50% vs 11.6%, P = 0.001) and a lesser degree of emphysema (mean % volumetric emphysema 6.7% vs 9.8%, P = 0.009). No relationship was observed between baseline and serial lung function parameters. Conclusion: ILA are frequent incidental findings in lung cancer screening. In the majority of cases these abnormalities do not appear to change significantly over a 2-year period of surveillance.

Annals of the American Thoracic Society, Dec 1, 2013

Background: Recent pathology studies report that the lungs of cigarette smokers may demonstrate s... more Background: Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localized subpleural foci of interstitial fibrosis associated with emphysema. Pathologically, this lesion has been termed smoking-related interstitial fibrosis, respiratory bronchiolitis-interstitial lung disease (ILD) with fibrosis, or airspace enlargement with fibrosis, but it is commonly misinterpreted on imaging and biopsy as a diffuse fibrosing interstitial pneumonia. The high-resolution computed tomography (HRCT) appearance of this process has not been defined. Objectives: We describe HRCT imaging of seven patients with this lesion present histologically. Measurements and Main Results: HRCT features consisted of patchy areas of mild reticulation around predominantly subpleural upper/mid zone emphysematous changes in all cases, with variable patchy ground-glass change in six cases. Pathologically, there were distinctly circumscribed foci of dense, often hyalinized, interstitial fibrosis mixed with emphysema; variable numbers of smoker's macrophages were present in the airspaces. The fibrosis was confined to the subpleural regions. Three patients with follow-up information were clinically stable. Conclusions: These data suggest that a CT pattern of patchy areas of reticular changes about predominantly upper zone emphysematous spaces may be seen in smokers who do not have clinical evidence of a diffuse ILD. We propose that this lesion be called respiratory bronchiolitis with fibrosis (RBF) to avoid confusion with other forms of ILD. RBF probably accounts for some of the cases of ILD seen in large radiologic surveys of smokers. The pathology literature indicates that RBF either has no functional effects or at worst represents mild, usually nonprogressive disease, and hence separation from other, more serious, forms of ILD is important. Recognition of this lesion on imaging may obviate the need for lung biopsy.

European Respiratory Society eBooks, Nov 1, 2022

Radiology Case Reports, Mar 31, 2024

European Respiratory Society eBooks, Nov 1, 2022

Respirology Case Reports

Immune reconstitution inflammatory syndrome (IRIS) in patients with human immunodeficiency virus ... more Immune reconstitution inflammatory syndrome (IRIS) in patients with human immunodeficiency virus (HIV) and Pneumocystis jirovecii pneumonia infection reflects an exaggerated inflammatory response of the host immune system to an antigen, which is temporally related to recovery of the immune system. Clinical manifestations include fever, cough, dyspnoea and hypoxia following the commencement of antiretroviral therapy. Diagnosis is made on clinical and radiological criteria with exclusion of other infective and non-infective causes. Unrecognized, IRIS may be associated with significant morbidity and mortality. Treatment with corticosteroids often results in prompt recovery. There is limited literature on radiological findings of Pneumocystis jirovecii pneumonia-associated IRIS. Here we describe cross-sectional imaging findings of PJP-IRIS in a patient following commencement of antiretroviral therapy.

Poster: "ECR 2012 / C-1066 / Prevalence of left atrial diverticula and accessory appendages ... more Poster: "ECR 2012 / C-1066 / Prevalence of left atrial diverticula and accessory appendages in patients with refractory atrial fibrillation: comparison with a control population using Dual Source CT" by: "O. Lazoura, T. Reddy, M. Shriharan, A. Lindsay, E. Nicol, M. Rubens, S. P. G. Padley; London/UK"

Respirology, 2020

Pulmonary complications in CTD are common and can involve the interstitium, airways, pleura and p... more Pulmonary complications in CTD are common and can involve the interstitium, airways, pleura and pulmonary vasculature. ILD can occur in all CTD (CTD-ILD), and may vary from limited, non-progressive lung involvement, to fulminant, life-threatening disease. Given the potential for major adverse outcomes in CTD-ILD, accurate diagnosis, assessment and careful consideration of therapeutic intervention are a priority. Limited data are available to guide management decisions in CTD-ILD. Autoimmunemediated pulmonary inflammation is considered a key pathobiological pathway in these disorders, and immunosuppressive therapy is generally regarded the cornerstone of treatment for severe and/or progressive CTD-ILD. However, the natural history of CTD-ILD in individual patients can be difficult to predict, and deciding who to treat, when and with what agent can be challenging. Establishing realistic therapeutic goals from both the patient and clinician perspective requires considerable expertise. The document aims to provide a framework for clinicians to aid in the assessment and management of ILD in the major CTD. A suggested approach to diagnosis and monitoring of CTD-ILD and, where available, evidence-based, diseasespecific approaches to treatment have been provided.

Internal Medicine Journal

Background: We report the prevalence and progression of incidentally detected interstitial lung a... more Background: We report the prevalence and progression of incidentally detected interstitial lung abnormalities (ILA) in the Queensland Lung Cancer Screening Study cohort. Methods: About 256 volunteers aged 60-74, with ≥30 pack years smoking history and forced expiratory volume in 1 s (FEV1) ≥50% predicted underwent low-dose computed tomography (CT) chest screening. Electronic search of baseline (T0) and 2-year followup (T2) CT reports identified candidate cases using Fleischner Society interstitial terminology. Candidate CT were reviewed in a randomised order by two experienced radiologists and a senior respiratory medicine trainee blinded to the existing reports. Scans were evaluated for the presence and extent of ILA using an in-house score, and graded for progression. Results: ILA were detected in 20/256 baseline cases (7.8%) with no incident cases detected at T2 surveillance imaging. Of these 20 cases, 9 (45%) had reticulation, 18 (90%) had ground glass change, 1 had traction bronchiectasis and 1 had randomly distributed nodularity. Seven cases with ground glass changes also had areas of reticulation, and only two had reticulation alone. All ILA were graded as minor except for traction bronchiectasis, which was moderate. Only one case progressed on T2 imaging. ILA were associated with the presence of auscultatory crackles (50% vs 11.6%, P = 0.001) and a lesser degree of emphysema (mean % volumetric emphysema 6.7% vs 9.8%, P = 0.009). No relationship was observed between baseline and serial lung function parameters. Conclusion: ILA are frequent incidental findings in lung cancer screening. In the majority of cases these abnormalities do not appear to change significantly over a 2-year period of surveillance.

The New Zealand Medical Journal, Feb 24, 2012

Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and... more Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and mortality. We undertook an audit (Auckland City Hospital, Auckland, New Zealand) to determine whether targeted assessment for incidental vertebral fractures on computed tomography (CT) examinations of the chest or abdomen in older people would detect previously unidentified vertebral fractures. In 175 consecutive patients aged >65 years, sagittal images of the spine were obtained by reformatting data from CT examinations of the chest or abdomen. Vertebral fractures were assessed using a semi-quantitative technique. The prevalence of vertebral fractures was 13%, with 41 vertebral fractures identified in 22 patients; 12/22 (55%) had vertebral fracture mentioned in the formal CT report, and 2/12 patients with contemporaneous plain films had vertebral fracture mentioned in the X-ray report. The vertebral fracture was newly identified in 17 (77%) patients, but vertebral fracture and osteoporosis were each listed in the relevant discharge summary or clinic letter for only 14% of patients, and only 31% of patients with fracture subsequently received osteoporosis treatment. In summary, assessing sagittal spine images reformatted from CT examinations of the chest or abdomen detects previously unidentified vertebral fractures, offering an undervalued opportunity to assess fracture risk and intervene with treatments that prevent fractures and reduce mortality.

B62. ACUTE PULMONARY EMBOLISM, 2011

Annals of the American Thoracic Society, 2013

Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localiz... more Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localized subpleural foci of interstitial fibrosis associated with emphysema. Pathologically, this lesion has been termed smoking-related interstitial fibrosis, respiratory bronchiolitis-interstitial lung disease (ILD) with fibrosis, or airspace enlargement with fibrosis, but it is commonly misinterpreted on imaging and biopsy as a diffuse fibrosing interstitial pneumonia. The high-resolution computed tomography (HRCT) appearance of this process has not been defined. We describe HRCT imaging of seven patients with this lesion present histologically. HRCT features consisted of patchy areas of mild reticulation around predominantly subpleural upper/mid zone emphysematous changes in all cases, with variable patchy ground-glass change in six cases. Pathologically, there were distinctly circumscribed foci of dense, often hyalinized, interstitial fibrosis mixed with emphysema; variable numbers of smo...

The New Zealand medical journal, Jan 24, 2012

Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and... more Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and mortality. We undertook an audit (Auckland City Hospital, Auckland, New Zealand) to determine whether targeted assessment for incidental vertebral fractures on computed tomography (CT) examinations of the chest or abdomen in older people would detect previously unidentified vertebral fractures. In 175 consecutive patients aged >65 years, sagittal images of the spine were obtained by reformatting data from CT examinations of the chest or abdomen. Vertebral fractures were assessed using a semi-quantitative technique. The prevalence of vertebral fractures was 13%, with 41 vertebral fractures identified in 22 patients; 12/22 (55%) had vertebral fracture mentioned in the formal CT report, and 2/12 patients with contemporaneous plain films had vertebral fracture mentioned in the X-ray report. The vertebral fracture was newly identified in 17 (77%) patients, but vertebral fracture and osteo...

Journal of Thoracic Imaging, 2012

Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonar... more Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonary ossification distributed in a characteristic branching pattern. It is usually associated with chronic interstitial inflammation and fibrosis but may occasionally be idiopathic. The underlying pathogenesis remains uncertain. Computed tomography findings characteristically show fine branching heterotopic bone formation within the lungs, often in a lower lobe distribution. A case of idiopathic dendriform ossification is described in a 34-year-old man who presented for investigation of hemoptysis.

PubMed, Sep 1, 2023

INTRODUCTION: Dermatomyositis (DM) is part of a rare spectrum of inflammatory myopathies with sys... more INTRODUCTION: Dermatomyositis (DM) is part of a rare spectrum of inflammatory myopathies with systemic manifestations including cutaneous, skeletal muscle, and internal organs. Pulmonary involvement includes respiratory muscle weakness, aspiration pneumonia, and interstitial lung disease (ILD). We present the case of rapidly progressive ILD due to DM. CASE PRESENTATION: A 42 year old Hispanic female with no prior medical history presented to the ED with a chief complaint of shortness of breath for 4 weeks. Patient stated she had been experiencing a red rash on her face, chest, and fingers for the past 3 months. In the last month she displayed progressive extremity weakness, intermittent wheezing, and facial swelling. CK was elevated at 6661 u/l. Quadriceps biopsy confirmed the diagnosis of DM. Patient was treated with IVIG, pulse steroids, and cyclophosphamide. Patient was transferred to MICU on hospital day 9 due to hypoxia. Patient required an embolization due to an expanding rectus sheath hematoma and couldn't be extubated. Hypoxia worsened despite maximal vent support on CMV, a trial of APRV, paralytics, and inhaled nitric oxide. On hospital day 15 patient was started on VV-ECMO. Despite prolonged aggressive support patient lacked improvement. Patient was made comfort measures by family and pronounced on hospital day 22. DISCUSSION: ILD occurs with DM in up to 35-45% of cases; with a mortality approaching 50% when rapidly progressive. This latter form is more common among patients with amyopathic DM, making this case more atypical. Radiologic and pathologic findings are variable. Ground-glass opacities on CT are associated with fatal ILD in DM. Therapies for DM with ILD have been difficult to research due to disease rarity. Steroids are frontline therapy, however response is variable. The need for additional therapy is common, particularly in rapidly progressive ILD. Reports exist of patients improving with tacrolimus, mycophenolate mofetil, rituximab, and IVIG. Cyclophosphamide can be beneficial but is reserved for severe cases due to its toxicity. CONCLUSIONS: DM is a rare disease that is commonly complicated by ILD. Prompt recognition and treatment is vital to prevent catastrophic decompensation, particularly in rapidly progressive cases.

Radiology Case Reports, Oct 1, 2023

Journal of Thoracic Imaging, Sep 1, 2012

Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonar... more Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonary ossification distributed in a characteristic branching pattern. It is usually associated with chronic interstitial inflammation and fibrosis but may occasionally be idiopathic. The underlying pathogenesis remains uncertain. Computed tomography findings characteristically show fine branching heterotopic bone formation within the lungs, often in a lower lobe distribution. A case of idiopathic dendriform ossification is described in a 34-year-old man who presented for investigation of hemoptysis.

Internal Medicine Journal, Jul 1, 2019

Background: We report the prevalence and progression of incidentally detected interstitial lung a... more Background: We report the prevalence and progression of incidentally detected interstitial lung abnormalities (ILA) in the Queensland Lung Cancer Screening Study cohort. Methods: About 256 volunteers aged 60-74, with ≥30 pack years smoking history and forced expiratory volume in 1 s (FEV1) ≥50% predicted underwent low-dose computed tomography (CT) chest screening. Electronic search of baseline (T0) and 2-year followup (T2) CT reports identified candidate cases using Fleischner Society interstitial terminology. Candidate CT were reviewed in a randomised order by two experienced radiologists and a senior respiratory medicine trainee blinded to the existing reports. Scans were evaluated for the presence and extent of ILA using an in-house score, and graded for progression. Results: ILA were detected in 20/256 baseline cases (7.8%) with no incident cases detected at T2 surveillance imaging. Of these 20 cases, 9 (45%) had reticulation, 18 (90%) had ground glass change, 1 had traction bronchiectasis and 1 had randomly distributed nodularity. Seven cases with ground glass changes also had areas of reticulation, and only two had reticulation alone. All ILA were graded as minor except for traction bronchiectasis, which was moderate. Only one case progressed on T2 imaging. ILA were associated with the presence of auscultatory crackles (50% vs 11.6%, P = 0.001) and a lesser degree of emphysema (mean % volumetric emphysema 6.7% vs 9.8%, P = 0.009). No relationship was observed between baseline and serial lung function parameters. Conclusion: ILA are frequent incidental findings in lung cancer screening. In the majority of cases these abnormalities do not appear to change significantly over a 2-year period of surveillance.

Annals of the American Thoracic Society, Dec 1, 2013

Background: Recent pathology studies report that the lungs of cigarette smokers may demonstrate s... more Background: Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localized subpleural foci of interstitial fibrosis associated with emphysema. Pathologically, this lesion has been termed smoking-related interstitial fibrosis, respiratory bronchiolitis-interstitial lung disease (ILD) with fibrosis, or airspace enlargement with fibrosis, but it is commonly misinterpreted on imaging and biopsy as a diffuse fibrosing interstitial pneumonia. The high-resolution computed tomography (HRCT) appearance of this process has not been defined. Objectives: We describe HRCT imaging of seven patients with this lesion present histologically. Measurements and Main Results: HRCT features consisted of patchy areas of mild reticulation around predominantly subpleural upper/mid zone emphysematous changes in all cases, with variable patchy ground-glass change in six cases. Pathologically, there were distinctly circumscribed foci of dense, often hyalinized, interstitial fibrosis mixed with emphysema; variable numbers of smoker's macrophages were present in the airspaces. The fibrosis was confined to the subpleural regions. Three patients with follow-up information were clinically stable. Conclusions: These data suggest that a CT pattern of patchy areas of reticular changes about predominantly upper zone emphysematous spaces may be seen in smokers who do not have clinical evidence of a diffuse ILD. We propose that this lesion be called respiratory bronchiolitis with fibrosis (RBF) to avoid confusion with other forms of ILD. RBF probably accounts for some of the cases of ILD seen in large radiologic surveys of smokers. The pathology literature indicates that RBF either has no functional effects or at worst represents mild, usually nonprogressive disease, and hence separation from other, more serious, forms of ILD is important. Recognition of this lesion on imaging may obviate the need for lung biopsy.

European Respiratory Society eBooks, Nov 1, 2022

Radiology Case Reports, Mar 31, 2024

European Respiratory Society eBooks, Nov 1, 2022

Respirology Case Reports

Immune reconstitution inflammatory syndrome (IRIS) in patients with human immunodeficiency virus ... more Immune reconstitution inflammatory syndrome (IRIS) in patients with human immunodeficiency virus (HIV) and Pneumocystis jirovecii pneumonia infection reflects an exaggerated inflammatory response of the host immune system to an antigen, which is temporally related to recovery of the immune system. Clinical manifestations include fever, cough, dyspnoea and hypoxia following the commencement of antiretroviral therapy. Diagnosis is made on clinical and radiological criteria with exclusion of other infective and non-infective causes. Unrecognized, IRIS may be associated with significant morbidity and mortality. Treatment with corticosteroids often results in prompt recovery. There is limited literature on radiological findings of Pneumocystis jirovecii pneumonia-associated IRIS. Here we describe cross-sectional imaging findings of PJP-IRIS in a patient following commencement of antiretroviral therapy.

Poster: "ECR 2012 / C-1066 / Prevalence of left atrial diverticula and accessory appendages ... more Poster: "ECR 2012 / C-1066 / Prevalence of left atrial diverticula and accessory appendages in patients with refractory atrial fibrillation: comparison with a control population using Dual Source CT" by: "O. Lazoura, T. Reddy, M. Shriharan, A. Lindsay, E. Nicol, M. Rubens, S. P. G. Padley; London/UK"

Respirology, 2020

Pulmonary complications in CTD are common and can involve the interstitium, airways, pleura and p... more Pulmonary complications in CTD are common and can involve the interstitium, airways, pleura and pulmonary vasculature. ILD can occur in all CTD (CTD-ILD), and may vary from limited, non-progressive lung involvement, to fulminant, life-threatening disease. Given the potential for major adverse outcomes in CTD-ILD, accurate diagnosis, assessment and careful consideration of therapeutic intervention are a priority. Limited data are available to guide management decisions in CTD-ILD. Autoimmunemediated pulmonary inflammation is considered a key pathobiological pathway in these disorders, and immunosuppressive therapy is generally regarded the cornerstone of treatment for severe and/or progressive CTD-ILD. However, the natural history of CTD-ILD in individual patients can be difficult to predict, and deciding who to treat, when and with what agent can be challenging. Establishing realistic therapeutic goals from both the patient and clinician perspective requires considerable expertise. The document aims to provide a framework for clinicians to aid in the assessment and management of ILD in the major CTD. A suggested approach to diagnosis and monitoring of CTD-ILD and, where available, evidence-based, diseasespecific approaches to treatment have been provided.

Internal Medicine Journal

Background: We report the prevalence and progression of incidentally detected interstitial lung a... more Background: We report the prevalence and progression of incidentally detected interstitial lung abnormalities (ILA) in the Queensland Lung Cancer Screening Study cohort. Methods: About 256 volunteers aged 60-74, with ≥30 pack years smoking history and forced expiratory volume in 1 s (FEV1) ≥50% predicted underwent low-dose computed tomography (CT) chest screening. Electronic search of baseline (T0) and 2-year followup (T2) CT reports identified candidate cases using Fleischner Society interstitial terminology. Candidate CT were reviewed in a randomised order by two experienced radiologists and a senior respiratory medicine trainee blinded to the existing reports. Scans were evaluated for the presence and extent of ILA using an in-house score, and graded for progression. Results: ILA were detected in 20/256 baseline cases (7.8%) with no incident cases detected at T2 surveillance imaging. Of these 20 cases, 9 (45%) had reticulation, 18 (90%) had ground glass change, 1 had traction bronchiectasis and 1 had randomly distributed nodularity. Seven cases with ground glass changes also had areas of reticulation, and only two had reticulation alone. All ILA were graded as minor except for traction bronchiectasis, which was moderate. Only one case progressed on T2 imaging. ILA were associated with the presence of auscultatory crackles (50% vs 11.6%, P = 0.001) and a lesser degree of emphysema (mean % volumetric emphysema 6.7% vs 9.8%, P = 0.009). No relationship was observed between baseline and serial lung function parameters. Conclusion: ILA are frequent incidental findings in lung cancer screening. In the majority of cases these abnormalities do not appear to change significantly over a 2-year period of surveillance.

The New Zealand Medical Journal, Feb 24, 2012

Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and... more Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and mortality. We undertook an audit (Auckland City Hospital, Auckland, New Zealand) to determine whether targeted assessment for incidental vertebral fractures on computed tomography (CT) examinations of the chest or abdomen in older people would detect previously unidentified vertebral fractures. In 175 consecutive patients aged >65 years, sagittal images of the spine were obtained by reformatting data from CT examinations of the chest or abdomen. Vertebral fractures were assessed using a semi-quantitative technique. The prevalence of vertebral fractures was 13%, with 41 vertebral fractures identified in 22 patients; 12/22 (55%) had vertebral fracture mentioned in the formal CT report, and 2/12 patients with contemporaneous plain films had vertebral fracture mentioned in the X-ray report. The vertebral fracture was newly identified in 17 (77%) patients, but vertebral fracture and osteoporosis were each listed in the relevant discharge summary or clinic letter for only 14% of patients, and only 31% of patients with fracture subsequently received osteoporosis treatment. In summary, assessing sagittal spine images reformatted from CT examinations of the chest or abdomen detects previously unidentified vertebral fractures, offering an undervalued opportunity to assess fracture risk and intervene with treatments that prevent fractures and reduce mortality.

B62. ACUTE PULMONARY EMBOLISM, 2011

Annals of the American Thoracic Society, 2013

Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localiz... more Recent pathology studies report that the lungs of cigarette smokers may demonstrate small localized subpleural foci of interstitial fibrosis associated with emphysema. Pathologically, this lesion has been termed smoking-related interstitial fibrosis, respiratory bronchiolitis-interstitial lung disease (ILD) with fibrosis, or airspace enlargement with fibrosis, but it is commonly misinterpreted on imaging and biopsy as a diffuse fibrosing interstitial pneumonia. The high-resolution computed tomography (HRCT) appearance of this process has not been defined. We describe HRCT imaging of seven patients with this lesion present histologically. HRCT features consisted of patchy areas of mild reticulation around predominantly subpleural upper/mid zone emphysematous changes in all cases, with variable patchy ground-glass change in six cases. Pathologically, there were distinctly circumscribed foci of dense, often hyalinized, interstitial fibrosis mixed with emphysema; variable numbers of smo...

The New Zealand medical journal, Jan 24, 2012

Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and... more Vertebral fractures are the most common osteoporotic fracture and predict subsequent fracture and mortality. We undertook an audit (Auckland City Hospital, Auckland, New Zealand) to determine whether targeted assessment for incidental vertebral fractures on computed tomography (CT) examinations of the chest or abdomen in older people would detect previously unidentified vertebral fractures. In 175 consecutive patients aged >65 years, sagittal images of the spine were obtained by reformatting data from CT examinations of the chest or abdomen. Vertebral fractures were assessed using a semi-quantitative technique. The prevalence of vertebral fractures was 13%, with 41 vertebral fractures identified in 22 patients; 12/22 (55%) had vertebral fracture mentioned in the formal CT report, and 2/12 patients with contemporaneous plain films had vertebral fracture mentioned in the X-ray report. The vertebral fracture was newly identified in 17 (77%) patients, but vertebral fracture and osteo...

Journal of Thoracic Imaging, 2012

Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonar... more Diffuse dendriform pulmonary ossification is a rare disorder characterized by widespread pulmonary ossification distributed in a characteristic branching pattern. It is usually associated with chronic interstitial inflammation and fibrosis but may occasionally be idiopathic. The underlying pathogenesis remains uncertain. Computed tomography findings characteristically show fine branching heterotopic bone formation within the lungs, often in a lower lobe distribution. A case of idiopathic dendriform ossification is described in a 34-year-old man who presented for investigation of hemoptysis.