AM Report: Tagged WBC Scan, CT findings of IPF

Tagged WBC Scan

  • HH taught us to think about using a tagged WBC scan as an advanced imaging tool to work up osteomyelitis, FUO, or vascular access infections
  • Tagged WBC scan uses WBCs labeled with Indium, Gallium or Technetium – blood drawn from the patient and the WBCs are labeled with a tracer and then re-injected into the patient, and patient scanned 24 hours later
  • Similar sensitivity/specificity to bone scans but can be false positive with inflammation such as fracture/Charcot arthropathy
  • Here is the Duke case series on tagged WBC scans that HH mentioned: http://ofid.oxfordjournals.org/content/1/2/ofu089.full

CT Findings of IPF

  • The 3 classic HRCT findings of IPF (pathologically defined by presence of usual interstitial pneumonia/UIP) are:
    • Bibasilar, peripheral, subpleural reticular opacities
    • Traction bronchiectasis
    • Honeycombing (i.e. subpleural clustered multi-tiered cystic air spaced w/ well-defined walls)
  • As always, I’m a big fan of http://radiopaedia.org/articles/idiopathic-pulmonary-fibrosis if you want to see more images
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