Tuberculosis radiology
[citation needed] In active pulmonary TB, infiltrates or consolidations and/or cavities are often seen in the upper lungs with or without mediastinal or hilar lymphadenopathy.
[1] Old healed tuberculosis usually presents as pulmonary nodules in the hilar area or upper lobes, with or without fibrotic scars and volume loss.
[citation needed] Nodules and fibrotic scars may contain slowly multiplying tubercle bacilli with the potential for future progression to active tuberculosis.
[1] 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.
[1] However, if a person has a positive response to the tuberculin skin test and no symptoms of the disease, chest radiographs can be used to rule out the possibility of pulmonary TB.
[citation needed] The chest X-ray and classification worksheet by the Centers for Disease Control and Prevention (CDC) of the United States is designed to group findings into categories based on their likelihood of being related to TB or non-TB conditions needing medical follow-up.
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 (tree-in-bud sign[3]).
The surrounding haziness can be either subtle or readily apparent and suggests coexisting airspace consolidation.
Discrete nodule(s) without calcification—One or more nodular densities with distinct borders and without any surrounding airspace opacification.
Discrete fibrotic scar with volume loss or retraction—Discrete linear densities with reduction in the space occupied by the upper lobe.
Associated signs include upward deviation of the fissure or hilum on the corresponding side with asymmetry of the volumes of the two thoracic cavities.
Discrete nodule(s) with volume loss or retraction—One or more nodular densities with distinct borders and no surrounding airspace opacification with reduction in the space occupied by the upper lobe.
