Granulomas

Preliminary Diagnosis: Granulomas

I. What imaging technique is first-line for this diagnosis?

Plain radiography

II. Describe the advantages and disadvantages of this technique for diagnosis of granulomas.

Advantages

• Highly sensitive for diagnosing granulomas

• Fast and inexpensive imaging modality

• Portable

Disadvantages

• Lacks specificity for diagnosing granulomas

III. What are the contraindications for the first-line imaging technique?

• No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.

IV. What alternative imaging techniques are available?

• CT imaging of the area of interest with and/or without contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of granulomas.

CT imaging of the area of interest with and/or without contrast

Advantages

• Highly sensitive and specific in detecting, characterizing, and diagnosing granulomas

• May guide treatment and therapy

• Offers more exquisite visualization of the surrounding soft tissues, osseous structures, and vasculature than plain radiography

• Better characterizes the primary process and any secondary complications than plain radiography

Disadvantages

• Exposes patients to ionizing radiation

• Less portable and more of an expensive imaging modality compared to plain radiography

VI. What are the contraindications for the alternative imaging techniques?

CT imaging of the area of interest with and/or without contrast

• May be contraindicated in pregnant patients

• IV contrast relatively contraindicated in patients with renal failure or contrast allergy