Radiology is used in the diagnosis of tuberculosis. Abnormalities on chest radiographs may be suggestive of, but are never diagnostic of TB, but can be used to rule out pulmonary TB. A posterior-anterior chest X-ray is the standard view used; other views or CT scans may be necessary. In active pulmonary TB, infiltrates or consolidations and/or cavities are often seen in the upper lungs with or without mediastinal or hilar lymphadenopathy. However, lesions may appear anywhere in the lungs. In HIV and other immunosuppressed persons, any abnormality may indicate TB or the chest X-ray may even appear entirely normal.

Old healed tuberculosis usually presents as pulmonary nodules in the hilar area or upper lobes, with or without fibrotic scars and volume loss. Bronchiectasis and pleural scarring may be present. Nodules and fibrotic scars may contain slowly multiplying tubercle bacilli with the potential for future progression to active tuberculosis. Persons with these findings, if they have a positive tuberculin skin test reaction, should be considered high-priority candidates for treatment of latent infection regardless of age. Conversely, calcified nodular lesions pose a very low risk for future progression to active tuberculosis. Abnormalities on chest radiographs may be suggestive of, but are never diagnostic of, TB. However, chest radiographs may be used to rule out the possibility of pulmonary TB in a person who has a positive reaction to the tuberculin skin test and no symptoms of disease.

These are films that are completely normal, with no identifiable cardiothoracic or musculoskeletal abnormality. This category comprises all findings typically associated with active pulmonary TB. In the US, refugees or immigration applicants with any of the following findings must submit sputum specimens for examination.

Infiltrate or consolidation - Opacification of airspaces within the lung parenchyma. Consolidation or infiltrate can be dense or patchy and might have irregular, ill-defined, or hazy borders. Any cavitary lesion - Lucency (darkened area) within the lung parenchyma, with or without irregular margins that might be surrounded by an area of airspace consolidation or infiltrates, or by nodular or fibrotic (reticular) densities, or both. The walls surrounding the lucent area can be thick or thin. Calcification can exist around a cavity. Nodule with poorly defined margins - Round density within the lung parenchyma, also called a tuberculoma. Nodules included in this category are those with margins that are indistinct or poorly defined. The surrounding haziness can be either subtle or readily apparent and suggests coexisting airspace consolidation.

Journal of Imaging and Interventional Radiology is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of interventional radiology.
Each issue in Journal of Imaging and Interventional Radiology covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field. The journal is a medium for original articles, reviews, pictorial essays, technical notes and case reports related to all fields of interventional radiology. Manuscripts can be submitted to online at https://www.imedpub.com/submissions/imaging-interventional-radiology.html or an attachment to mail: radiology@emedscholar.comBest wishes

Ann Jose

Journal coordinator

Journal of Imaging and Interventional Radiology

intervradiology@longdomjournal.org